论文部分内容阅读
目的探讨慢性肾脏病(CKD)与缺血性卒中(CIS)短期预后的关系。方法收集2011年1月至2015年3月巴中市中心医院神经内科收治的CIS患者103例,记录其年龄、性别、血清肌酐、美国国立卫生研究院卒中量表(NIHSS)评分等基线资料。根据肾小球滤过率(eGFR)水平将患者分为有CKD(34例,eGFR≥60 mL·min~(-1)·1.73m~(-2))组和无CKD(69例,eGFR<60mL·min~(-1)·1.73m~(-2))组;根据改良Rankin量表(mRS)评分将患者分为预后良好(62例,mRS评分≤2分)组和预后不良(41例,mRS评分>2)组,对各组临床病理特征进行比较,应用logistic进行伴发CKD和CIS预后不良的危险因素回归分析。结果多因素Logistic回归分析显示:高血压、糖尿病、蛋白尿和IMT≥1.3mm均为急性CIS伴发CKD的独立危险因素(OR分别为2.273、1.237、1.308、1.347,均P<0.05),而IMT<1.0mm则是独立保护因素(OR0.443,P<0.05)。糖尿病、糖尿病前期、CKD(eGFR<60mL·min~(-1)·1.73m~(-2))、蛋白尿均为急性CIS预后不良的独立危险因素(OR分别为1.497、1.420、2.051、2.546,均P<0.05)。结论伴有CKD的CIS患者共存病较多,CKD是CIS预后不良的独立危险因素之一,且与CIS的部分危险因素密切相关,并对CIS短期预后有着显著的影响。
Objective To investigate the relationship between chronic kidney disease (CKD) and short-term prognosis of ischemic stroke (CIS). Methods 103 patients with CIS who were admitted to Department of Neurology, Central Hospital of Bazhong from January 2011 to March 2015 were recruited. Baseline data including age, gender, serum creatinine, NIHSS score were collected. Patients were divided into two groups according to the glomerular filtration rate (eGFR): CKD (34 eGFR≥60 mL · min ~ (-1) · 1.73m -2) and CKD without eGFR (69 eGFR The patients were divided into two groups according to modified Rankin Scale (mRS): good prognosis (62 cases, mRS score≤2 points) and poor prognosis 41 cases, mRS score> 2). The clinical and pathological features of each group were compared. Logistic regression analysis was performed on risk factors associated with poor prognosis of CKD and CIS. Results Multivariate logistic regression analysis showed that hypertension, diabetes mellitus, proteinuria and IMT≥1.3mm were both independent risk factors for acute CIS with CKD (OR = 2.273,1.237,1.308,1.347, all P <0.05), while IMT <1.0mm was an independent protective factor (OR0.443, P <0.05). Diabetes mellitus, pre-diabetes, CKD (eGFR <60 mL · min -1 · 1.73 m -2) and proteinuria were both independent risk factors for poor prognosis of acute CIS (OR = 1.497,1.420,2.051,2.546 , All P <0.05). Conclusions There are more coexisting diseases in CIS patients with CKD. CKD is one of the independent risk factors for poor prognosis of CIS. It is closely related to some risk factors of CIS and has a significant impact on short-term prognosis of CIS.