老年心源性卒中患者肾功能不全发生及影响因素分析

Incidence and Contributing Factors to Renal Insufficiency in Older Patients with Cardioembolic Stroke

目的探讨非瓣膜性房颤致心源性卒中的老年患者肾功能不全发生率及其影响因素。方法回顾性分析纳入2013年1月-2016年1月在首都医科大学宣武医院神经内科住院的非瓣膜性房颤致心源性卒中患者195例(年龄≥65岁),以估测肾小球滤过率(eGFR)评价肾功能,eGFR<60ml/(min·1.73m^2)为肾功能不全,并分为肾功能不全组(34例)和无肾功能不全组(161组)。观察非瓣膜性房颤致心源性卒中老年患者肾功能不全发生率及其影响因素。结果195例非瓣膜性房颤致心源性卒中老年患者,肾功能不全发生率为17.4%(34/195);多因素logistic回归分析显示,高龄(≥75岁)是非瓣膜性房颤致心源性卒中老年患者发生肾功能不全的独立危险因素(CW=0.021,P<0.01)。结论非瓣膜性房颤致心源性卒中老年患者肾功能不全发生率高,高龄是该类患者发生肾功能不全的独立危险因素。

Objective To explore the incidence and contributing factors to renal insufficiency in older patients with cardioembolic stroke caused by non-valvular atrial fibrillation.Methods From January 2013 to January 2016, 195 older patients with cardioembolic stroke caused by non .valvular atrial fibrillation were enrolled.Estimated glomerular filtration rate (eGFR)<60 ml/(min·1.73m^2) was defined as renal insufficiency.The patients were divided into renal insufficiency group (34 cases) and non-renal insufficiency group (161 cases).The incidence and contributing factors to renal insufficiency were assessed.Results The incidence of renal insufficiency was 17.4%(34/195 ) in older patients with cardioembolic stroke caused by non-valvular atrial fibrillation.Logistic regression analysis showed that age (≥75 years old) was the contributing factor to renal insufficiency in these patients (OR = 0.021<0.01 ).Conclusion The incidence of renal insufficiency is high in older patients with cardioembolic stroke caused by non-valvular atrial fibrillation.Age (≥75 years old) is an independent predictive factor for renal dysfunction in these patients.