脑卒中患者肾功能损伤情况及其危险因素研究  

Prevalence of Renal Impairment and the Related Risk Factors among Patients with Acute Stroke

作　　者：盛蕾[1] 张兰坤[1] 刘定华[2] 彭岚[2] 胡丹[1] 丁彩霞[1] 肖婧[1] 李传游[1] 朱羽佳[1] 凌志香[1] 姜寒[1] 汤银燕[1] 

机构地区：[1]南京中医药大学第二附属医院神经内科,江苏省南京市210017 [2]江阴市人民医院神经内科

出　　处：《中国全科医学》2011年第32期3690-3692,共3页Chinese General Practice

摘　　要：目的调查脑卒中患者的肾功能损伤情况,探讨脑卒中患者肾功能损伤的危险因素。方法选择902例脑卒中患者为研究对象。观察患者的性别、年龄、高血压病、糖尿病、吸烟史、血压、血糖、血脂、血尿酸、血红蛋白和蛋白尿;采用简化"肾脏膳食改良试验"(modification of diet in renal disease,MDRD)法估测肾小球滤过率(estimated glomerular filtration rates,GFR);按照肾脏病患者生存质量指导(kidney disease outcome quality initiative,K/DOQI)中的肾功能分期标准,将患者分为(1)GFR≥90 ml.min-1.(1.73 m2)-1(A组),(2)60≤GFR<90 ml.min-1.(1.73 m2)-1(B组),(3)GFR<60 ml.min-1.(1.73 m2)-1(C组)3组。采用Logistic多因素回归分析影响GFR下降的危险因素(P<0.05)。结果分别有50.6%和13.4%的脑卒中患者GFR<90 ml.min-1.(1.73m2)-1和肾功能减退;慢性肾脏病(chronic kidney disease,CKD)患病率为25.1%。其中老年患者肾功能减退发生率高于中青年患者(P<0.01);无论老年还是中年女性,肾功能减退发生率均高于男性,差异均有统计学意义(P<0.001)。Logistic多因素回归分析提示老年、女性、吸烟、糖尿病、冠心病、高脂血症、高尿酸血症是肾功能减退的危险因素。结论脑卒中患者肾功能损伤发生率较高,与老年、女性、吸烟、糖尿病、冠心病、高脂血症、高尿酸血症有密切关系。Objective To investigate the prevalence of renal impairent and its related risk factors in patients with cerebral infarctions.Methods Totally 902 adult patients with cerebral infarctions were included in this study.Age,sex and blood pressure were recorded.Levels of hemoglobulim,serum cretinine,blood ureanitrogen,blood liqid,serum uric acid were measured.Glomerular filtration rates（GFR） were estimated by the modification of diet in renal disease study equation（MDRD）.These cases were divided into three groups：normal group GFR≥90 ml·min-1·（1.73 m2）-1（A group）,mild renal insufficiency group 60 ml·min-1·（1.73 m2）-1≤GFR90 ml·min-1·（1.73 m2）-1（B group）and moderate renal insufficiency group GFR60 ml·min-1·（1.73 m2）-1（C group）.according to the criterion on classification of GFR in kidney disease outcome quality initiative（K/DOQI）.Results The GFR levels of 50.6% of the patients were below 90 ml·min-1·（1.73 m2）-1,and 13.4% were below 60 ml·min-1（·1.73 m2）-1.The incidence rate of chronic kidney disease（CKD）was 25.1%.Elder patients had a higher prevalence than middle-aged patients 8.6%（P0.01）;kidney function decline rate were higher in women than in men for both the elder and middle-aged population（P0.001）.Binary logistic regression analysis showed that the risk factors for kidney function decline were age,female,smoking,diabetes,coronary atherosclerotic heart disease,hyperuricemic and lipids disorder.Conclusion The prevalence of renal impairment is high in patients with cerebral infarction,and the related risk factors include age,female,smoking,diabetes,coronary artherosclerotic heart disease,lipids disorder and hyperuricemic.

关 键 词：脑卒中 肾功能不全 危险因素 

分 类 号：R743.33[医药卫生—神经病学与精神病学]