肾病综合征并发脑梗死的临床特点分析

Clinical features of nephrotic syndrome complicated with cerebral infarction

目的探讨肾病综合征并发脑梗死的临床特点。方法采用回顾性分析的方法,总结肾病综合征并发脑梗死(脑梗死组)26例患者的临床特征,并选取同期收治的肾病综合征无并发脑梗死的患者作为对照组进行对照研究,分析肾病综合征并发脑梗死的原因。结果脑梗死组纤维蛋白原增高、高脂血症、血小板增高以及水肿的病例数明显大于对照组,差异有统计学意义(P<0.01);低蛋白血症、高血压的病例数亦大于对照组,差异有统计学意义(P<0.05)。两组病例的血清学检验结果比较,脑梗死组血浆白蛋白水平明显下降,与对照组比较,差异有统计学意义(P<0.01);纤维蛋白原、D-二聚体和血小板脑梗死组明显高于对照组(P<0.01);Chol和TG脑梗死组亦高于对照组,差异有统计学意义(P<0.05)。结论肾病综合征并发脑梗死与患者血液高凝状态、脂类代谢和蛋白代谢紊乱密切相关。肾病综合征所导致的水肿、高纤维蛋白原、高脂血症、血小板增高、高D-二聚体、低蛋白血症和高血压可能是肾病综合征并发脑梗死的主要原因。

Objective To investigate the clinical features of nephrotic syndrome complicated with cerebral infarction （NSCI）. Methods The clinical features of 26 patients with NSCI （NSCI group） were retrospectively analyzed, and com- pared with that of nephrotic syndrome patients without cerebral infarction （control group） who received by our hospital at the same period, so as to find out the cause of nephrotic syndrome complicated with cerebral infarction. Results Compared with control group, a distinct higher occurrence of fibrinogen increasing, hyperlipidemia, and platelet in- creasing is observed in NSCI group, with statistically significant differences （P 〈 0.01）; meanwhile, the incidence of hypoproteinaemia and hypertension is also found to be higher than NSCI group, and the result is statistically signifi- cant（P 〈 0.05）. Moreover, according to the result of serological test, an obvious decreasing of the plasma albumin level is found in NSCI group, and the difference with that of control group was statistically significant （P 〈 0.01）; mean- while, the level of fibrinogen,D-dimer and platelet was also found remarkably higher in NSCI group than in control group, with a statistically significant result（P 〈 0.01）; besides, the level of Chol and TG of NSCI group was also found higher than control group, with a statistically significant difference （P 〈 0.05）. Conclusion Nephrotic syndrome compli- cated with cerebral infarction is closely related to a high agglutination condition, and metabolic disturbance of lipid and protein. Moreover, the symptoms of nephrotic syndrome, including edema, high fibrinogen, hyperlipidemia,increas- ing of platelet, high level of D-dimer, hypoproteinemia, and hyperlipemia are inferred to be the main causes for cere- bral infarction.