首发急性脑梗死患者伴肾功能损伤的相关危险因素分析

Analysis of risk factors associated with renal function injury in patients with first-episode acute cerebral infarction

目的探讨首发急性脑梗死(ACI)患者伴肾功能损伤的相关危险因素。方法收录2017年2月到2018年12月在河北医科大学第二医院神经内科住院病房接受诊治的首发急性脑梗死患者,依据肾功能是否损伤分为肾功能损伤组[血清胱抑素C(CysC)≥1.03 mg/L,病例组]和肾功能正常组(CysC<1.03 mg/L,对照组);收集患者的一般临床资料、化验室指标、相关辅助检查等信息,并对可能的相关危险因素进行单因素和多因素分析。结果依据纳入标准共纳入首发急性脑梗死患者305例,合并肾功能损伤100例,占比为32.79%。两组间年龄、高血压、糖尿病、冠心病、高同型半胱氨酸(Hcy)、超敏C反应蛋白(Hs-CRP)的差异有统计学意义(均P<0.05)。Logistic回归分析显示,年龄、高血压、糖尿病、Hcy、Hs-CRP均为首发急性脑梗死患者伴发肾功能损伤的独立危险因素。结论年龄、高血压、糖尿病、Hcy、Hs-CRP与首发急性脑梗死患者肾功能损伤的发生相关。

Objective To investigate the risk factors associated with renal impairment in patients with firstepisode acute cerebral infarction.Methods The first acute cerebral infarction patients who were admitted to the Department of Neurology,Second Hospital of Hebei Medical University from February 2017 to December 2018 were included in the renal function injury group according to whether the renal function was damaged[serum cystatin C(CysC)≥1.03 mg/L,case Group]and normal renal function group(CysC<1.03 mg/L,control group).General clinical data,laboratory indicators,related auxiliary examination and other information were collected.Univariate and multivariate analyses were used to analyze possible risk factors.Results According to the inclusion criteria,305 patients with first-episode acute cerebral infarction were included,and 100 patients had renal dysfunction,accounting for 32.79%.The results of single factor analysis showed that there were significant differences in age,hypertension,diabetes,coronary heart disease,homocysteine(Hcy)and high-sensitivity C-reactive protein(Hs-CRP)(all P<0.05).After adjusting for relevant confounding factors,Logistic regression analysis showed that there was a statistically significant difference in age,hypertension,diabetes,Hcy,and Hs-CRP,which was an independent risk factor for patients with first-episode acute cerebral infarction complicated with renal impairment.Conclusion Age,hypertension,diabetes,Hcy,and Hs-CRP were associated with renal impairment in patients with first-episode acute cerebral infarction.