脑梗死患者肾小球滤过率与颈动脉粥样硬化的相关性研究  

Correlation between estimated glomerular filtration rate and carotid atherosclerosis in ischemic stroke patients

作　　者：刘振宝[1] 赵迎春[1] 潘晓春[1] 李旗[1] 张瑜 高丹宇[1] 王丽丽[1] 葛士骝[2] 

机构地区：[1]上海交通大学附属第一人民医院松江分院神经内科,01699 [2]上海交通大学附属第一人民医院松江分院超声科,01699

出　　处：《中华老年心脑血管病杂志》2014年第11期1133-1136,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：上海市松江区科学技术攻关项目(QK1106)

摘　　要：目的探讨肾小球滤过率(glomerular filtration rate,GFR)下降对脑梗死患者颈动脉粥样硬化的影响。方法选择720例急性脑梗死患者,根据GFR水平分为GFR下降组136例[估算GFR<60ml/(min·173m2)]和GFR正常组584例,经彩色多普勒超声检测颈动脉内膜中层厚度(CIMT)、阻力指数和颈动脉粥样硬化斑块,比较2组CIMT、阻力指数和双侧颈动脉斑块的发生率,并探讨该人群CIMT与GFR下降及其他各种血管危险因素的相关性。结果与GFR正常组患者比较,GFR下降组患者的CIMT更厚[(0.91±0.19)mmvs(0.84±0.16mm)],阻力指数大(0.78±0.05 vs 0.73±0.08),颈动脉斑块的发生率高(85.29%vs 63.01%),差异有统计学意义(P<0.05)。Pearson相关分析显示,CIMT与年龄、收缩压、TC、LDL-C、空腹血糖、糖尿病史呈正相关(P<0.05,P<0.01),与估算GFR呈负相关(r=-0.292,P=0.000),年龄、收缩压、LDL-C、糖尿病史是CIMT的独立影响因素(P<0.05,P<0.01),校正上述危险因素后,估算GFR水平与CIMT的相关性不显著(P=0.089)。结论 GFR下降患者颈动脉粥样硬化发生率高,GFR下降可能与其他血管危险因素共同作用加剧了CIMT增厚,而GFR与CIMT无独立相关性。Objective To study the effect of low glomerular filtration rate （GFR） on carotid atherosclerosis in ischemic stroke patients.Methods Seven hundred and twenty acute ischemic stroke patients were divided into low GFR group （n=136） and normal GFR group （n=584） according to their GFR.Their carotid IMT,carotid IMT resistent index,and carotid atherosclerotic plaques detected by Doppler ultrosonography were compared.Correlation of carotid IMT with low GFR and other vascular risk factors was studied.Results The carotid IMT,carotid IMT resistent index,and the incidence of carotid atherosclerotic plaques were greater in low GFR group than in norma lGFR group （0.91±0.19 mm vs 0.84±0.16 mm,P=0.012;0.78±0.05 vs 0.73±0.08,P=0.018;85.29％ vs 63.01％,P=0.021）.Age,systolic blood pressure,serum levels of TC,LDL-C,fasting plasma glucose,history of diabetes mellitus,and eGFR were significantly correlated with carotid IMT （P＜0.01,P＜0.05）.Age,systolic blood pressure,serum LDL-C level and history of diabetes mellitus were the independent risk factors for carotid IMT.However,eGFR was not significantly correlated with carotid IMT （P=0.089）.Conclusion The incidence of carotid atherosclerosis is high in low GFR patients.Low GFR and other vascular risk factors may lead to thicher carotid IMT.However,GFR itself is not independently correlated with carotid IMT.

关 键 词：脑梗死 肾小球滤过率 颈动脉疾病 动脉粥样硬化 超声检查 多普勒 彩色 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]