尿中微量白蛋白与脑梗死患者病情严重程度、预后及复发的关系

目的：探讨尿中微量白蛋白与脑梗死患者病情严重程度、预后及复发的关系。方法采用前瞻性队列研究方法,86例脑梗死患者根据尿白蛋白排泄率（UAER）分为2组：尿微量白蛋白组（MAU 组）36例（尿白蛋白排泄率30~300 mg/24 h）；尿白蛋白正常组（NAU 组）50例（尿白蛋白排泄率〈30 mg/24 h）,入院时采用美国国立卫生院卒中评分（National Institutes of Health Stroke Scale,NIHSS）及格拉斯哥昏迷量表（Glasgow Coma Stroke,GCS）评分评定患者的病情严重程度；用 Barthel 生活指数（Barthel index,BI）评定患者的日常生活能力,用改良的 Rankin 量表（modified Rankin Scale,mRS）评定患者的病残程度,并于脑梗死后3、12、24月时再次进行 BI 及 mRS 评分,并随访2年以观察脑梗死复发情况。结果MAU 组入院时 NIHSS 评分（7.09±2.24）分,高于 NAU 组（4.96±2.11）分（P 〈0.05）,GCS 评分（13.4±2.62）分,低于 NAU 组（14.5±2.87）分（P 〈0.05）；MAU 组 BI 评分在入院时、脑梗死后3、12、24月均低于 NAU 组（P 〈0.05）；MAU 组在入院时、脑梗死后3、12、24月 BI 评分、mRS 评分均高于 NAU 组（P 〈0.05）。随访2年,MAU 组再发1次6例（16.67%）,再发2次3例（8.33%）,再发3次及以上者1例（2.78%）；NAU 组再发1次5例（10%）,再发2次2例（4%）,再发3次及以上者0例（0%）；MAU 组均高于 NAU 组（P 〈0.05）。结论脑梗死伴 MAU 患者与脑梗死 NAU 患者比较,前者病情较重、预后较差,复发率更高。

Relationship between microalbuminuria and severity,prognosis and relapse in cerebral infarction patients

Objective To investigate the relationship between microalbuminuria and severity,prognosis and relapse in cerebral infarction patients.Methods Prospective cohort study was followed-up.86 cases of pa-tients with cerebral infarction were divided into 2 group：urinary albumin excretion rate （UAER）：microalbu-minuria group（MAU group,n=36）（UAER 30-300 mg/24 h）;no microalbuminuria group（NAU group,n=50） （UAER 〈30 mg/24 h）.The score of NIHSS and GCS were used to assess the severity on admission;Barthel index were used to assess the activity of daily living;Modified Rankin Scale were used to assess the disability degree.Barthel index and modified Rankin Scale were assessed after 3 months、12 months and 24 months after infarction again.Observing the relapse in two years.Results The NIHSS was （7.09 ± 2.24）and GCS was （13.4±2.62）in MAU group.The NIHSS was （4.96 ±2.1 1）and GCS was （14.5 ±2.87）in NAU group. NIHSS in MAU group was higher than NAU group（P 〈0.05）.GCS in MAU group was lower than NAU group（P 〈0.05）;Barthel index in MAU group were lower than NAU group on admission .Modified Rankin Scale were higher than NAU group on admission.In two years 6 patients relapsed once,3 patients relapsed twice and 1 patient relapsed three times in MAU group.In NAU group,5 patients relapsed once,2 patients re-lapsed twice but no one relapsed three times;the recurrent number in MAU group were all higher than NAU group（P 〈0.05）.Conclusions Stroke patients with microalbuminuria was more serious ,worse prognosis and recurrent more frequent than that with out microalbuminuria.