老年患者头颅MR腔隙灶改变与尿微量白蛋白的相关关系及其危险因素的探讨

Correlation between MR lacune of presumed vascular origin and microalbuminuria and in elderly patients

目的:探讨70岁以上患者头颅MR腔隙灶改变与尿微量白蛋白(MAU)间的相关关系及MR腔隙灶改变的危险因素。方法:本组资料中的研究对象均来自2014年1-12月于广州市第一人民医院老年病科住院的70岁以上的老年患者。记录其年龄、性别、吸烟史、饮酒史、收缩压、高血压史、糖尿病史、冠心病史、非瓣膜性心房颤动病史,以及尿素氮、肌酐、尿酸、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、超敏C-反应蛋白、MAU、头颅MR等结果。根据头颅MR改变,分为无腔隙灶组和有腔隙灶组。结果:(1)与无腔隙灶患者比较,有腔隙灶组患者动脉收缩压较高,同时MAU阳性率升高、MAU中位数也明显升高。(2)多因素Logistic回归分析提示,动脉收缩压升高、MAU阳性以及MAU升高均为是否发生腔隙灶改变的独立危险因素,并且均与腔隙灶的严重程度呈正相关。结论:MAU是头颅MR腔隙灶改变的危险因素。年龄、高血压是头颅MRI腔隙灶改变的危险因素。

Objective To investigate the correlation of lacune of presumed vascular origin and microalbu- minuria in elderly inpatients. Methods 237 elderly patients （184 males and 53 females） at Guangzhou First People＇s Hospitalwho aged from 70 to 94 years old with a median age of 83.92± 5.32 were included in this study. We collected data on age, gender, medical history, smoking history, renal function test, blood lipid test, C-reactive protein, mieroalbuminuria, cerebral MR. Logistic regression was conducted to analyze all the data. Based on the MR findings, the patients were divided into two groups ： a group with lacune of presumed vascular origin （ 132 patients） and a control group （105 patients）. Results The group with laeune of presumed vascular origin had higher mean systolic blood pressure than the control group. Median MAU was higher in the groupwith laeune of presumed vascular origin.Single factor or multiple factors logistic regression showed that increased systolic blood pressure and positive rates of MAU and MAU were independent risk factors for lacune of presumed vascular origin and were also significantly associated with the severity of lacune of presumed vascular origin. Conclusion Microalbuminuria is significantly associated with lacune of presumed vascular origin in elderly patients.