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背景:国外研究发现脑卒中危险因素与微量白蛋白尿有一定的关系,但结果并不一致。目的:研究急性脑梗死患者微量白蛋白尿的发生率、与脑卒中危险因素及脑梗死复发的关系。设计:以急性脑梗死患者和有脑梗死危险因素者为研究对象,以健康老年人为对照组的病例-对照研究。单位:一所大学医院的神经内科病房。对象:选择2000-01/2001-12重庆医科大学附属第一医院神经内科脑梗死及有脑梗死危险因素的住院病例共214例,年龄50～80岁。急性脑梗死组(发病在1周之内)78例,脑梗死危险因素组,如高血压、糖尿病、冠心病、短暂性脑缺血发作或脑卒中史(6个月以上)患者56例,28例健康老年人作为对照组。其中联合组包括急性脑梗死患者78例和脑梗死危险因素组中有短暂性脑缺血发作或脑卒中史者31例,共109例。方法:测定过夜空腹12h以上血白蛋白、血肌酐、血糖、总胆固醇、总三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇;用放射免疫法测定早晨第1次尿中白蛋白。主要观察指标:①终点结局指标:随访2年新血管事件(包括脑卒中复发、心肌梗死和血管性死亡)的发生率;②危险性指标:脑梗死危险因素与微量白蛋白尿的关系;③替代指标:各组微量白蛋白尿的发生率。结果:急性脑梗死患者中微量白蛋白尿者占35%,显著高于脑梗死危险因素组(15
Background: Foreign study found that stroke risk factors and microalbuminuria have a certain relationship, but the results are not consistent. Objective: To study the incidence of microalbuminuria in patients with acute cerebral infarction and its relationship with the risk factors of stroke and the recurrence of cerebral infarction. DESIGN: A case-control study of patients with acute cerebral infarction and risk factors for cerebral infarction and healthy elderly controls. Unit: a neurology ward at a university hospital. PARTICIPANTS: A total of 214 inpatients with cerebral infarction and risk factors for cerebral infarction were selected from the Department of Neurology, the First Affiliated Hospital of Chongqing Medical University from January 2000 to December 2001, aged from 50 to 80 years. There were 78 cases of acute cerebral infarction (incidence within 1 week), 56 cases of cerebral infarction risk factors such as hypertension, diabetes, coronary heart disease, transient ischemic attack or stroke history (more than 6 months) Twenty-eight healthy elderly people served as control group. In the combined group, there were 31 cases with transient ischemic attack or stroke in 78 patients with acute cerebral infarction and cerebral infarction risk factors group, a total of 109 cases. Methods: Serum albumin, serum creatinine, blood glucose, total cholesterol, total triglyceride, high density lipoprotein cholesterol and low density lipoprotein cholesterol were measured 12 hours after fasting overnight. The first urine albumin in morning was determined by radioimmunoassay. MAIN OUTCOME MEASURES: ① End-point outcome: Follow-up 2-year incidence of new vascular events (including recurrent stroke, myocardial infarction and vascular death); ② Risk indicators: the relationship between risk factors of cerebral infarction and microalbuminuria; ③ Substitution index: the incidence of microalbuminuria in each group. Results: Microalbuminuria accounted for 35% of patients with acute cerebral infarction, which was significantly higher than those of risk factors of cerebral infarction (15