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目的探讨慢性肾脏病(CKD)与缺血性脑卒中患者并发脑微出血的关系。方法选取2011年8月—2014年11月太仓市第一人民医院神经内科收治的新发缺血性脑卒中患者242例,均于入院2周内行颅脑磁敏感加权成像以判断脑梗死区内是否存在脑微出血,同时计算估算肾小球滤过率(eGFR)以判断是否合并CKD。CKD与缺血性脑卒中患者并发脑微出血的相关性采用Spearman秩相关分析。结果共118例(48.8%)患者发生脑微出血。不同性别、年龄、吸烟史及是否合并高血压、糖尿病、高脂血症患者脑微出血发生率比较,差异无统计学意义(P>0.05);合并CKD患者脑微出血发生率高于未合并CKD患者(P<0.05)。并发脑微出血患者平均eGFR低于未并发脑微出血患者(P<0.05)。Spearman秩相关分析结果显示,CKD与缺血性脑出血患者并发脑微出血呈正相关(rs=0.84,P<0.01)。结论合并CKD的缺血性脑卒中患者脑微出血发生率较高,eGFR可作为缺血性脑卒中患者并发脑微出血的独立预测指标。
Objective To investigate the relationship between chronic kidney disease (CKD) and cerebral micro-hemorrhage in patients with ischemic stroke. Methods From August 2011 to November 2014, 242 patients with newly diagnosed ischemic stroke were admitted to Department of Neurology, First People’s Hospital of Taicang City. All patients underwent magnetic resonance imaging and magnetic resonance Whether there is cerebral micro-hemorrhage, and calculate the estimated glomerular filtration rate (eGFR) to determine whether the merger of CKD. Correlation between CKD and cerebral microbleeds in patients with ischemic stroke was analyzed by Spearman rank correlation analysis. Results A total of 118 patients (48.8%) had cerebral microbleeds. There was no significant difference in the incidence of cerebral microbleeds between patients with different sex, age, smoking history and whether complicated with hypertension, diabetes and hyperlipidemia (P> 0.05). The incidence of cerebral microbleeds in patients with CKD was higher than that without merger CKD patients (P <0.05). The mean eGFR in patients with cerebral hemorrhage was lower than that in patients without cerebral hemorrhage (P <0.05). Spearman rank correlation analysis showed that CKD was positively correlated with cerebral hemorrhage in patients with ischemic cerebral hemorrhage (rs = 0.84, P <0.01). Conclusions The incidence of cerebral micro-hemorrhage in ischemic stroke patients with CKD is high, and eGFR can be used as an independent predictor of cerebral micro-hemorrhage in ischemic stroke patients.