急性脑梗死患者微量白蛋白尿与卒中相关危险因素的关系探讨  

Analysis on the Relationship between Microalbuminuria and the Risk Factors of Acute Ischemic Stroke

作　　者：郑天衡[1] 高建[1] 朱鑫璞[1] 黄海侠[1] 王少石[1] 

机构地区：[1]上海市第一人民医院分院神经内科,上海200081

出　　处：《中国卒中杂志》2014年第5期399-403,共5页Chinese Journal of Stroke

基　　金：上海市虹口区卫生局资助课题(虹卫1104-03)

摘　　要：目的探讨微量白蛋白尿（microalbuminuria,MAU）与急性脑梗死危险因素及其病情严重程度的关系。方法采用前瞻性研究方法,连续收集2011年7月～2013年7月在上海市第一人民医院分院神经内科住院且发病时间72 h内的急性脑梗死患者166例为研究对象,其中男89例,女77例,应用免疫比浊法测定患者的尿微量白蛋白水平,根据检测结果将所有患者分成MAU阳性组（81例）和MAU阴性组（85例）。比较两组间一般临床资料及生化指标是否存在差异,并采用Logistic回归分析评估MAU与脑梗死危险因素的相关性。结果 166例患者中,有81例（48.8%）存在MAU。MAU阳性组与阴性组比较,糖尿病（χ2=8.116,P=0.004）、收缩压（t=2.735,P=0.007）、美国国立卫生研究院卒中量表（National Institutes of Health Stroke Scale,NIHSS）（t=2.612,P=0.01）、血糖（t=2.68,P=0.008）、低密度脂蛋白胆固醇（t=2.217,P=0.028）和C反应蛋白（t=5.548,P=0.000）差异有显著性。Logistic回归分析显示,糖尿病[优势比（odds ratio,OR）为1.51,95%可信区间（confidence interval,CI）1.26～2.47,P=0.01]、收缩压（OR 1.47,95%CI 1.01～1.17,P=0.004）、低密度脂蛋白胆固醇（OR 2.43,95%CI 1.01～5.37,P=0.03）和C反应蛋白（OR 1.79,95%CI 1.09～1.21,P=0.005）均为MAU的独立危险因素。结论 MAU与高血压、糖尿病、C反应蛋白、血脂等脑梗死危险因素密切相关。Objective To investigate the relationship between microalbuminuria（MAU） and the risk factors of acute ischemic stroke.Methods A prospective observation study was adopted in this study. One hundred and sixty-six consecutive patients with acute ischemic stroke were included and divided into two groups： MAU positive group（n=81） which was defined as MAU level 20～300 mg/L, and negative group（n=85） which was defined as MAU level 20 mg/L. The clinical data and laboratory results in two groups were compared.Results Diabetes（χ2=8.116, P=0.004）, systolic pressure（t =2.735, P=0.007）, National Institutes of Health Stroke Scale（NIHSS）（t =2.612, P =0.01）, fasting blood glucose（t =2.68, P =0.008）, low density lipoprotein cholesterol（t =2.217, P =0.028） and C-reactive protein（t =5.548, P =0.000） in MAU positive group were significantly higher than those in MAU negative group. Logistic regression analysis shows diabetes（[odds ratio, OR] 1.51, 95%[confidence interval, CI] 1.26～2.47, P =0.01）, systolic pressure（OR 1.47, 95%CI 1.01～1.17, P =0.004）, low density lipoprotein cholesterol（OR 2.43, 95%CI 1.01～5.37, P=0.03） and C-reactive protein（OR 1.79, 95%CI 1.09～1.21, P=0.005） were dependent risk factors of MAU.Conclusion MAU increasing was related to the risk factors of ischemic stroke, including hypertension, diabetes, C-reactive protein and low density lipoprotein cholesterol. MAU increasing might indicate the severity of illness in patients with acute ischemic stroke.

关 键 词：微量白蛋白尿 脑梗死 

分 类 号：R743.33[医药卫生—神经病学与精神病学]