西安地区保留肾功能的老年脑卒中患者血清碱性磷酸酶水平与一年死亡的相关研究  

Relationship between serum ALP level and 1-year mortality in Xi’an elderly cerebral stroke patients with preserved renal function

作　　者：张瑜瑜 刘仲仲 逯青丽 王静[1] 刘佩 张娜[1] 蔺雪梅 王芳[1] 吴松笛 Zhang Yuyu;Liu Zhongzhong;Lu Qingli;Wang Jing;Liu Pei;Zhang Na;Lin Xuemei;Wang Fang;Wu Songdi(Department of Neurology,Xi'an No.1 Hospital,Xi'an 710002,Shaanxi Province,China)

机构地区：[1]西北大学附属第一医院西安市第一医院神经内科,710002

出　　处：《中华老年心脑血管病杂志》2021年第12期1276-1279,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：陕西省重点研发计划项目(2021SF-333);西安市科技计划项目[201805104YX12SF38(2),20YXYJ0008(1)];西安市卫生健康委员会科研项目(2020ms03,2020yb05,2021yb33)。

摘　　要：目的探讨西安地区保留肾功能的老年脑卒中患者血清碱性磷酸酶(ALP)水平与1年死亡的关系。方法纳入西安市四所三级甲等医院2015年1~12月连续入院的脑卒中患者的临床资料,筛选出保留肾功能且年龄≥65岁的脑卒中患者1040例,患者按ALP水平进行五分位分组,Q1组207例(ALP<58.8 U/L),Q2组194例(ALP 58.8~69.6 U/L),Q3组220例(ALP 69.7~81.0 U/L),Q4组207例(ALP 81.1~96.0 U/L),Q5组212例(ALP≥96.1 U/L)。对患者进行1年的随访,并记录死亡事件发生情况。将ALP分别按照连续变量和五分位分组变量处理。通过单因素和多因素Cox回归分析ALP水平与1年死亡的关系。结果 1年随访结束时,Q5组1年病死率明显高于Q1组、Q2组、Q3组和Q4组(32.1%vs 14.2%、12.3%、21.7%、19.8%,P=0.014)。校正相关混杂因素后,多因素Cox回归分析显示,ALP水平每升高10 U/L,患者1年死亡风险升高9%(OR=1.09,P=0.000);以Q1组为参照,Q5组1年死亡风险显著增加1.03倍(OR=2.03,P=0.029)。结论血清ALP水平升高是保留肾功能的老年脑卒中患者1年死亡的独立危险因素,ALP≥96.1 U/L时可显著增加患者1年病死率。Objective To study the relationship between serum ALP level and 1-year mortality in Xi’an elderly cerebral stroke(CS) patients with preserved renal function(PRF).Methods A total of 1040 ≥65 years old CS patients with PRF admitted to 4 Xi’an tertiary hospitals from January 2015 to December 2015 were included in this study.The patients were followed up for 1 year, during which the mortality was recorded.The ALP was divided into Q1 group, Q2 group, Q3 group, Q4 group and Q5 group.The relationship between serum ALP level and 1-year mortality in elderly CS patients with PRF was analyzed by univariate Cox and multivariate Cox regression analysis respectively.Results The 1-year mortality was significantly higher in Q5 group than in Q1-Q4 groups by the end of 1-year follow-up(32.1% vs 14.2%,12.3%,21.7%,19.8%,P=0.014).Mmultivariate Cox regression analysis showed that the risk of 1-year mortality in elderly CS patients with PRF increased by 9% when the serum ALP level increased per 10 U/L after adjustment for the confounding factors(OR=1.09,P=0.000).The risk of 1-year mortality was 1.03-fold higher in Q5 group than in Q1 group(OR=2.03,P=0.029).Conclusion Elevated serum ALP level is an independent risk factor for the 1-year mortality in elderly CS patients with PRF,and the 1-year mortality increases significantly when the serum level of ALP was ≥96.1 U/L.

关 键 词：卒中 碱性磷酸酶 血管钙化 肾小球滤过率 

分 类 号：R743.3[医药卫生—神经病学与精神病学]