急性心肌梗死患者脑卒中发病与肾脏功能的相关性分析  

The correlation analysis between the occurrence of stroke in patients with acute myocardial infarction and kidney function

作　　者：林莉[1] 沈珈谊 吴小燕[1] 叶士勇[1] Lin Li

机构地区：[1]浙江省丽水市中心医院,323000

出　　处：《浙江临床医学》2025年第2期184-186,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨急性心肌梗死患者脑卒中发病与肾脏功能的关系。方法选取2022年1月至2023年6月期间本院接受治疗的246例急性心肌梗死患者的临床资料,根据肾小球滤过率(eGFR)分为肾功能正常组(n=132)与肾功能不良组(n=114),比较两组患者的一般资料。并依据是否发生脑卒中分为脑卒中组(n=18)和非脑卒中组(n=228),进行单因素和Logistic多因素分析识别急性心肌梗死患者脑卒中发病的危险因素,并分析肾功能不良与急性心肌梗死患者发生脑卒中各危险因素的相关性。结果肾功能不良组患者中女性比例较多,年龄较大,多合并高血压、永久性房颤、冠心病、充血性心力衰竭、脑卒中/短暂性脑缺血发作(TIA)/体循环栓塞史,CHA2DS2-VASc评分较高,差异有统计学意义(P<0.05)。单因素分析显示,脑卒中组与非脑卒中组在高血压、房颤、既往经皮冠状动脉介入治疗(PCI)史、充血性心力衰竭、脑卒中/TIA/体循环栓塞史、外周血管疾病、肾功能、CHA2DS2-VASc评分方面的差异有统计学意义(P<0.05)。Logistic多因素分析显示,阵发性房颤、脑卒中/TIA/体循环栓塞史、合并外周血管疾病、肾功能不良、CHA2DS2-VASc评分高为急性心肌梗死患者脑卒中发病的危险因素(P<0.05)。阵发性房颤、脑卒中/TIA/体循环栓塞史、合并外周血管疾病、CHA2DS2-VASc评分与肾功能不良均呈正相关(P<0.05)。结论阵发性房颤、脑卒中/TIA/体循环栓塞史、合并外周血管疾病、肾功能不良、CHA2DS2-VASc评分高为急性心肌梗死患者脑卒中发病的危险因素,且急性心肌梗死患者发生脑卒中的各危险因素与肾功能不良呈正相关,提示心肌梗死患者脑卒中发病与肾脏功能存在相关性。Objective To explore the relationship between the occurrence of stroke in patients with acute myocardial infarction and kidney function.Methods Clinical data of 246 patients with acute myocardial infarction admitted to our hospital from January 2022to June 2023 were selected.Patients were divided into the normal the kidney function group(n=132)and kidney dysfunction group(n=114)based on estimated glomerular filtration rate(EGFR),and general data of the two groups were compared.Additionally,patients were divided the into stroke group(n=18)and the non-stroke group(n=228)based on the occurrence of stroke,and univariate and logistic multivariate analyses were performed to identify risk factors for stroke in patients with acute myocardial infarction,as well as to analyze the correlation between impaired kidney function and various risk factors for stroke in these patients.Results The impaired kidney function group had a higher proportion of females,older age,and more frequent comorbidities such as hypertension,permanent atrial fibrillation,coronary heart disease,congestive heart failure,and history of stroke/TIA/systemic embolism,with a higher CHA2DS2-VASc score,and these differences were statistically significant(P<0.05).Univariate analysis showed that there were statistically significant differences between the stroke group and the non-stroke group in terms of hypertension,atrial fibrillation,previous PCI history,congestive heart failure,history of stroke/TIA/systemic embolism,peripheral vascular disease,kidney function,and CHA2DS2-VASc score(P<0.05).Logistic multivariate analysis indicated that paroxysmal atrial fibrillation,history of stroke/TIA/systemic embolism,concomitant peripheral vascular disease,impaired kidney function,and high CHA2DS2-VASc score were risk factors for stroke in patients with acute myocardial infarction(P<0.05).Paroxysmal atrial fibrillation,history of stroke/TIA/systemic embolism,concomitant peripheral vascular disease,and CHA2DS2-VASc score were all positively correlated with impaired kid

关 键 词：急性心肌梗死 脑卒中 发病 肾脏功能 

分 类 号：R542.22[医药卫生—心血管疾病] R743.3[医药卫生—内科学]