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目的探讨维持性血液透析(MHD)并发脑卒中的相关危险因素。方法回顾性分析40例MHD并发脑卒中患者(卒中组)的临床资料,根据CT或者MRI分为缺血组(15例)与出血组(25例),50例同期单纯MHD患者(非卒中组)作为对照组。结果卒中组较非卒中组原发病为糖尿病肾病发生率、透前血压及平均动脉压、低密度脂蛋白(LDL)、超敏C-反应蛋白(hs-CRP)均偏高;从亚组分析看,缺血性卒中组尿酸(UA)较高,出血性卒中组血小板(PLT)较低(P<0.05)。Logistic回归分析显示原发病为糖尿病、透前平均动脉压、超敏C-反应蛋白(hs-CRP)为血液透析发生脑卒中的危险因素;尿酸为血液透析发生缺血性卒中的危险因素;血小板为血液透析发生出血性卒中的保护性因素。结论 MHD患者发生脑卒中与糖尿病肾病、高血压、尿酸及血小板、hs-CRP水平相关。
Objective To explore the related risk factors of maintenance hemodialysis (MHD) complicated with stroke. Methods The clinical data of 40 patients with stroke complicated by MHD (stroke group) were retrospectively analyzed. According to CT or MRI, they were divided into 15 groups with hemorrhage (25 cases), 50 cases with simple MHD (non-stroke group ) As a control group. Results Compared with non-stroke group, the incidence of diabetic nephropathy, mean arterial pressure, mean arterial pressure, LDL, and hs-CRP in stroke group were higher than those in non-stroke group. Analysis, ischemic stroke group uric acid (UA) is higher, hemorrhagic stroke platelet (PLT) was lower (P <0.05). Logistic regression analysis showed that the primary disease was diabetes mellitus, mean arterial pressure before antecedents and hs-CRP were risk factors for stroke in hemodialysis patients. Uric acid was a risk factor for ischemic stroke in hemodialysis patients. Platelets are protective factors for hemorrhagic stroke in hemodialysis. Conclusions Stroke in patients with MHD is associated with diabetic nephropathy, hypertension, uric acid, platelet and hs-CRP levels.