皮层下动脉硬化性脑病进展危险因素分析

Analysis of Risk Factors for the Progression of Subcortical Arteriosclerotic Encephalopathy

目的分析皮层下动脉硬化性脑病(SAE)进展程度与肾脏功能指标的相关性。方法选择医院收治的SAE患者68例设为SAE组,同期行头颅MRI、神经系统查体及智能评分均正常者50例设为对照组。根据简明精神状态量表(MMSE)评分及患者的自我评分情况将SAE组患者分为SAE轻度组(31例)、SAE中度组(29例)、SAE重度组(8例)。检测相关肾脏功能指标;采用Logistic回归分析SAE危险因素。结果与对照组比较,SAE组高血压病、冠状动脉粥样硬化性心脏病、糖尿病、肾小球滤过率、血肌酐、胱抑素C水平差异均有统计学意义(均P<0.05)。SAE重度亚组及轻度亚组肾小球滤过率水平差异有统计学意义(P<0.05)。调整混杂因素后,高血压、冠状动脉粥样硬化性心脏病及肾小球滤过率水平为SAE的独立危险因素(P<0.05);轻度SAE的独立危险因素为高血压、糖尿病和肾小球滤过率(P<0.05);中度SAE的独立危险因素为高血压和GFR(P<0.05)。与SAE轻度亚组比较,SAE重度亚组GFR水显著降低(P<0.05)。结论高血压、肾小球滤过率等是SAE和中度SAE的独立危险因素。

Objective To analyze the correlation of the progression of subcortical arteriosclerotic encephalopathy(SAE)with renal function indicators.Methods A total of 68 SAE patients admitted to the hospital were selected as the SAE group,while 50 subjects who had normal results in head MRI,neurological examination,and intelligence score during the same period were selected as the control group.According to the Mini-Mental State Examination(MMSE)score and the patients'self-scoring,the patients in the SAE group were divided into the mild-SAE group(31 cases),moderate-SAE group(29 cases),and severe-SAE group(eight cases).Relevant kidney function indicators were detected.The Logistic regression analysis was used to explore the risk factors of SAE.Results Compared with those in the control group,the hypertension,coronary atherosclerotic heart disease,diabetes mellitus,glomerular filtration rate(GFR),serum creatinine,and cystatin C levels in the SAE group were significantly different(P<0.05).There was a statistically significant difference in GFR level between the severe-and mild-SAE groups(P<0.05).After adjustment of confounding factors,hypertension,coronary atherosclerotic heart disease and glomerular filtration rate were independent risk factors for SAE(P<0.05).The independent risk factors of mild SAE were hypertension,diabetes mellitus and GFR(P<0.05).The independent risk factors of moderate SAE were hypertension and GFR(P<0.05).Compared with those in the mild-SAE group,the GFR level in the severe-SAE group significantly decreased(P<0.05).Conclusion Hypertension and GFR are independent risk factors of SAE and moderate SAE.