血液透析患者无症状脑梗塞危险因素的探讨

Risk factors of silent cerebral infarction in hemodialysis patients

目的探讨维持性血液透析（CHD）患者发生无症状脑梗塞（SCI）的危险因素。方法对无脑血管疾病症状的115例CHD患者和48例尿毒症非透析患者进行头颅核磁共振成像（MRI）检查，研究SCI的发生率，并使用多元回归分析，探讨CHD患者SCI的危险因素。结果CHD患者SCI的发生率显著高于对照组（分别是46．9％、8．3％，P〈0．01）。对所有受试者进行多元回归分析的结果表明，SCI的危险因素包括：慢性肾衰竭、高血压、吸烟和年龄（R^2=0．54，P〈0．01）。在CHD组，年龄和吸烟是独立危险因素（R^2=0．63，P〈0．01），而与CHD持续时间无关。结论进行CHD的慢性肾衰竭患者SCI的发生率增加，CHD患者的年龄、高血压和吸烟习惯与SCI有密切关系。

Objective To explore the prevalence and risk factors of silent cerebral infarction （SCI） in hemodialysis（HD） patients. Method Cranial magnetic resonance imaging（MRI） was performed in 115 HD patients without symptomatic cerebrovascular diseases and in 48 controls. We investigated the incidence of asymptomatic CI and performed cross-sectional study using multiple logistic analysis to assess the relationship between silent CI and the risk factors. Results The prevalence of asymptomatic CI was significantly higher in HD patients than in the healthy control group（46. 9% vs 8. 3%,P〈0. 01）. Multiple logistic regression analysis showed that independent risk factors of asymptomatic CI were chronic renal failure, hypertension, smoking and age（R^2 = 0. 54,P〈0. 01）o In CHD patient group, age and smoking were shown to be independent risk factors（R^2 = 0.63, P〈0. 01 ）, while no nelation of the duration of DH. Conclusions The finding of the present study indicate that chronic renal failure on maintainence by hemodialysis increases the prevalence of asymptomatic CI and that age, hypertension and smoking habits are also significantly associated with silent CI in HD patients.