尿蛋白排泄率与颅内动脉粥样硬化的关系

Relationship between Urinary Albumin Excretion and Intracranial Atherosclerosis

【目的】探讨尿蛋白排泄率(UAER)与颅内动脉粥样硬化的关系。【方法】选择79例合并原发性高血压病的动脉血栓形成性脑梗死患者,平均年龄66.34(S=9.87)岁,于入院后完善头颅磁共振血管造影+磁共振成像(MRA+MRI)和直接检眼镜眼底检查等,对MRA所示颅内动脉粥样硬化严重程度和眼底动脉硬化进行分级评定,挑选20例原发性高血压患者为对照,对所有入选者进行UAER检测,比较梗死组和对照组一般情况和UAER;对脑梗死患者血管病变分级和UAER进行相关分析;以20!g/min为界,将脑梗死患者分为高UAER组和低UAER组,比较两组一般情况和重度眼底动脉硬化的发生率。【结果】对照组和梗死组平均年龄、性别构成、高血压病程、收缩压及舒张压等无差异(P>0.05),脑梗死组UAER值高于对照组(P<0.05);血管病变级别和UAER之间正相关(r=0.618,P=0.015);高UAER组重度眼底动脉硬化的发生率高于低UAER组。【结论】升高的UAER增加原发性高血压患者脑梗死的发生风险;这种风险的增加可能由UAER和颅内动脉粥样硬化严重程度相关所致。

[Objectives]To investigate the relationship between urinary albumin excretion rate （UAER）and intracranial artery atherosclerosis. [ Methods ] A total of 79 cerebral infarction with cerebral artery occlusion patients accompanying with essential hypertension were enrolled, the average age was 66.34（S=9.87） years. All patients undergone MRI ＋MRA and examination of fundus oculi by direct ophthalmoscope after admitted the severity of intracranial artery atherosclerosis was assessed by MRA, and fundus oculi artery sclerosis was categorized. Twenty hypertensive patients were selected as control group, UAER was measured in all participants; the general conditions and UAER were compared between cerebral infarction group and control group, the correlation between UAER and severity of intracranial artery atherosclerosis was analyzed in cerebral infarction group; Furthermore, according to the UAER at level of 20 μg/min, all cerebral infarction patients were divided into two groups, the general conditions and severity of fundus oculi artery sclerosis were compared between high UAER group and low UAER group. [ Result ｜ There were no significant difference between cerebral infarction group and control group in average ages, consist of sex, course of hypertention, systolic pressure and diastolic pressure （P 〈 0.05）, cerebral infarction group showed a higher UAER than control group（t=2.432, P 〈 0.05）; UAER was positively correlated with the severity of intracranial artery atherosclerosis （r=0.618, P=0.015） ;high UAER group showed a higher prevalence of more severe fundus oculi artery sclerosis. [ Conclusions ] The higher UAER will increased risk of cerebral infarction in the hypertensive population, maybe because UAER was significantly associated with the severity of intracranial atherosclerosis.