摘要/Abstract
摘要： 目的 ·探讨中老年人群肾小球滤过率（glomerular filtration rate，GFR）与急性缺血性脑卒中的发生风险及临床意义。方法 ·回顾性分析 2016年 1月— 2018年 6月于中国人民解放军联勤保障部队第九○八医院神经内科的 292例住院患者的临床资料，包括性别、年龄、舒张压、体质量指数、吸烟与饮酒史、红细胞计数、头颅影像，以及血糖、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、总胆固醇、GFR、血尿素氮、血尿酸、血肌酐、谷草转氨酶、同型半胱氨酸水平等。按 GFR水平将患者分为 GFR正常组与 GFR偏低组，比较 2组患者的临床特征。采用多因素 Logistic回归分析探讨 GFR与急性缺血性脑卒中发生的关系。结果 · 292例患者中， GFR正常组 154例（52.74%）、GFR偏低组 138例（47.26%）。采用 χ2检验或 t检验分析的结果显示， 2组患者的性别、体质量指数、吸烟史、饮酒史、红细胞计数、血糖、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、总胆固醇、谷草转氨酶、同型半胱氨酸等指标间差异均无统计学意义，而年龄、舒张压、 GFR、血尿素氮、血尿酸、血肌酐等指标间差异均具有统计学意义（均 P<0.05）。2组患者的急性缺血性脑卒中发生率分别为 41.56%（64/154）、59.42%（82/138）（χ29.291，P0.002）。与 GFR正常组比较， GFR偏低组患者的急性缺血性脑卒中发生风险 OR（95% CI）在调整相关危险因素前为 2.06（1.29～ 3.29）（P0.002），而在调整后为 2.04（1.01～ 4.12）（P0.047）。结论 ·中老年人群 GFR偏低与急性缺血性脑卒中的发生相关。
关键词: 卒中, 急性缺血性脑卒中, 肾小球滤过率, 多因素Logistic回归分析
Abstract:
Objective · To explore the occurrence risk and clinical significance of glomerular filtration rate (GFR) level and acute ischemic stroke in middle-aged and elderly population. Methods · The clinical data of 292 hospitalized patients in the Department of Neurology at the No.908 Hospital of the Peoples Liberation Army Joint Logistics Support Force Jan. 2016 to Jun. 2018 were retrospectively analyzed, including gender, age, diastolic blood pressure, body mass index, smoking and drinking history, erythrocyte count, brain images, and the level of blood glucose, low density lipoprotein-cholesterol, high density lipoprotein-cholesterol, total cholesterol, GFR, blood urea nitrogen, blood uric acid, serum creatinine, glutamic-oxaloacetic transaminase, homocysteine. According to the GFR level, patients were divided into normal GFR group and low GFR group. The clinical characteristics were compared between two groups. Multivariate Logistic regression analysis was used to investigate the relationship between GFR level and the occurrence of acute ischemic stroke. Results · The number of patients in normal GFR group and low GFR group was 154 (52.74%) and 138 (47.26%), respectively. Chi-square test or t test analysis showed that there was no significant difference in gender, body mass index, smoking history, drinking history, erythrocyte count, blood glucose, low density lipoprotein-cholesterol, high density lipoprotein-cholesterol, total cholesterol, glutamic-oxaloacetic transaminase and homocysteine between two groups, and significant difference in age, diastolic blood pressure, GFR, blood urea nitrogen, blood uric acid, serum creatinine (all P<0.05). The incidence rate of acute ischemic stroke in normal GFR group and low GFR group was 41.56% (64/154) and 59.42% (82/138), respectively (χ29.291, P0.002). Compared with the normal GFR group, the occurrence risk OR (95% CI) of acute ischemic stroke in lower GFR group was 2.06 (1.29–3.29) (P0.002) and 2.04 (1.01–4.12) (P0.047) before and after adjusted the related risk factors. Conclusion · The low GFR levels are associated with the occurrence of acute ischemic stroke in middle-aged and elderly population.
Key words: stroke, acute ischemic stroke, glomerular filtration rate (GFR), multivariate Logistic regression analysis
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