肾小球滤过率与急性缺血性小卒中患者早期神经功能恶化的关系

Association of glomerular filtration rate with early neurological deterioration in patients with acute ischemic minor

目的探讨肾小球滤过率(eGFR)与急性缺血性小卒中(AIM)患者早期神经功能恶化(END)的关系。方法选取2020年1月至2022年12月黑龙江中医药大学附属第三医院神经内科收治的AIM患者126例,根据是否发生END分为END组和非END组。对比两组基础资料、实验室指标以及eGFR水平,分析eGFR与AIM患者出现END的关系。结果END组年龄、入院美国国立卫生研究院卒中量表(NIHSS)评分以及血清Hcy水平高于非END组,eGFR水平低于非END组(P<0.05)。Logistic分析显示,年龄大、NIHSS评分高、血同型半胱氨酸(Hcy)水平高及eGFR下降与AIM患者发生END存在相关性(P<0.05)。ROC曲线分析,NIHSS评分、Hcy联合eGFR预测AIM后发生END的曲线下面积为0.890,联合预测的敏感度明显高于单项指标(P<0.01),联合预测特异度与单项指标差异无统计学意义(P>0.05)。结论eGFR下降与AIM患者END的发生有关,是导致END的独立危险因素,联合检测NIHSS评分、血清Hcy水平及eGFR有助于对AIM患者END的风险预测。

Objective To investigate the relationship between glomerular filtration rate(eGFR)and short-term prognosis in patients with acute ischemic minor(AIM).Methods 126 AIM patients admitted to the department of neurology of the third affiliated hospital of Heilongjiang university of Chinese medicine from January 2020 to December 2022 were divided into END group and non-END group according to whether END occurred.Basic data,laboratory indicators and eGFR levels were compared between the two groups.The relationship between eGFR and END in AIM patients was analyzed.Results Age,admission N1HSS score and serum Hey level in END group were higher than those in non-END group,eGFR level was lower than those in non-END group(P<0.05).Logistic analysis showed that older age,higher NIHSS score,higher serum Hey level and lower eGFR were correlated with the occurrence of END in AIM patients(P<0.05).ROC curve analysis showed that the area under the curve of END occurred after the three indexes combined predicted AIM was 0.890.and the sensitivity of the combined prediction was significantly higher than that of the single index(P<0.01),while there was no statistical significance between the specificity of the combined prediction and the single index(P>0.05).Conclusion The eGFR decline is associated with END in AIM patients and is an independent risk factor for END.Combined detection of NIHSS score,serum Hey level and eGFR is helpful to predict the risk of END in AIM patients.