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目的:观察脑卒中患者尿微量清蛋白的水平,探讨其与脑卒中发生的关系。方法:采用ELISA的方法检测了来自全国7个临床中心病例对照的尿微量清蛋白水平。1890例脑卒中患者经头颅CT或核磁共振检查证实(其中缺血性脑梗死854例,腔隙性脑梗死528例,脑出血508例),1595例性别、年龄匹配的对照组经严格检查排除脑卒中。结果:缺血性脑梗死组和脑出血组的尿微量清蛋白水平分别为(13.26±17.28)和(14.14±15.93)mg/L,明显高于对照组(10.34±11.33)mg/L(P<0.01);腔隙性脑梗死组的尿微量清蛋白水平(10.25±11.18)mg/L,与对照组比较差异无统计学意义(P>0.05)。Logistic回归分析结果显示:在调整了其他脑血管病危险因素后,尿微量清蛋白330 mg L者发生缺血性脑梗死(OR=1.6,95%的可信区间1.073-2.268,P< 0.05)和脑出血(OR=1.7,95%的可信区间1.054-2.650,P<0.05)的危险性增加;尿微量清蛋白异常与腔隙性脑梗死的关系无统计学意义(P>0.05)。结论:尿微量清蛋白水平与脑卒中发生的关系密切,是脑卒中独立的危险因素。
Objective: To observe the level of urinary albumin in patients with stroke and to explore its relationship with stroke. Methods: Urine microalbumin level was examined by ELISA in seven clinical centers across the country. 1890 stroke patients were confirmed by skull CT or MRI (854 ischemic cerebral infarction, 528 lacunar cerebral infarction and 508 cerebral hemorrhage), and 1595 gender-age-matched control groups were excluded from strict examination Stroke. Results: Urinary albumin levels of ischemic cerebral infarction group and cerebral hemorrhage group were (13.26 ± 17.28) and (14.14 ± 15.93) mg / L, respectively, which were significantly higher than those of the control group (10.34 ± 11.33) mg / L <0.01). Urinary albumin level in lacunar infarction group was (10.25 ± 11.18) mg / L, which showed no significant difference compared with control group (P> 0.05). Logistic regression analysis showed that ischemic cerebral infarction occurred in urine microalbumin 330 mg L (OR = 1.6, 95% confidence interval 1.073-2.268, P <0.05) after adjusting for other risk factors of cerebrovascular disease (OR = 1.7, 95% CI: 1.054-2.650, P <0.05). There was no significant correlation between urinary microalbuminuria and lacunar infarction (P> 0.05). Conclusion: The level of urine microalbumin is closely related to the occurrence of stroke and is an independent risk factor for stroke.