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目的研究短暂性脑缺血发作(TIA)患者微量白蛋白尿水平与颈总动脉粥样硬化的关系。方法选取TIA患者108例,根据尿微量白蛋白/肌酐浓度值(ACR)将患者分为尿蛋白正常(NMAU)组45例(ACR<30 mg/g),微量蛋白尿(MAU)组63例(ACR30~300 mg/g),比较2组颈动脉中内膜厚度(CIMT),并计算颈动脉斑块积分。结果 2组颈动脉CIMT及颈动脉积分差异明显(P<0.05),MAU组稳定斑块数量减少,易损斑块数量增多,与NMAU组比较差异显著(P<0.05),2组既往脑卒中史、高血压病程、收缩压、舒张压、ABCD2评分及糖尿病病程、空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(Hb A1c)、高脂血症、总胆固醇(TC)、低密度脂蛋白胆固醇(LDLC)水平有显著差异(P<0.05)。年龄、性别、体重指数(BMI)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDLC)无明显差异(P>0.05)。Spearman相关分析显示,TIA患者的尿微量白蛋白与CIMT呈显著正相关(r=0.318,P<0.05)。结论 TIA患者微量白蛋白尿水平与颈动脉粥样硬化有关。
Objective To investigate the relationship between microalbuminuria and carotid atherosclerosis in patients with transient ischemic attack (TIA). Methods A total of 108 patients with TIA were enrolled in this study. According to urinary albumin / creatinine concentration (ACR), 45 patients (ACR <30 mg / g) and 63 patients with microalbuminuria (MAU) (ACR30 ~ 300 mg / g). The carotid intima-media thickness (CIMT) was compared between two groups and carotid artery plaque score was calculated. Results There were significant differences in carotid artery CIMT and carotid artery scores between the two groups (P <0.05). The number of stable plaques and the number of vulnerable plaque in MAU group were significantly increased (P <0.05) History of diastolic blood pressure, systolic blood pressure, diastolic blood pressure, ABCD2 score and duration of diabetes, fasting blood glucose (FPG), 2 h postprandial blood glucose (2 h PG), Hb A1c, hyperlipidemia, total cholesterol TC), low density lipoprotein cholesterol (LDLC) levels were significantly different (P <0.05). Age, sex, body mass index (BMI), triglyceride (TG) and high density lipoprotein cholesterol (HDLC) had no significant difference (P> 0.05). Spearman correlation analysis showed that there was a significant positive correlation between urine microalbumin and CIMT in patients with TIA (r = 0.318, P <0.05). Conclusions Microalbuminuria in TIA patients is related to carotid atherosclerosis.