血液透析患者無癥狀腦梗塞危險(xiǎn)因素的探討

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1、血液透析患者無癥狀腦梗塞危險(xiǎn)因素的探討2006年12月第6卷第6期JClinNephrolDecember2006,Vo1.6,No.6血液透析患者無癥狀腦梗塞危險(xiǎn)因素的探討陳華茜黃云芳劉巍楊濤趙黎黃光敏【摘要】目的探討維持性血液透析(CHD)患者發(fā)生無癥狀腦梗塞(SCI)的危險(xiǎn)因素.方法對(duì)無腦血管疾病癥狀的115例CHD患者和48例尿毒癥非透析患者進(jìn)行頭顱核磁共振成像(MRI)檢查,研究SCI的發(fā)生率,并使用多元回歸分析,探討CHD患者SCI的危險(xiǎn)因素.結(jié)果CHD患者SCI的發(fā)生率顯著高于對(duì)照組(

2、分別是46.9,8.3,P<O.叭).對(duì)所有受試者進(jìn)行多元回歸分析的結(jié)果表明,SCI的危險(xiǎn)因素包括:慢性腎衰竭,高血壓,吸煙和年齡(R2=0.54,P<0.01).在CHD組,年齡和吸煙是獨(dú)立危險(xiǎn)因素(R2=0.63,P<0.【)1),而與CHD持續(xù)時(shí)間無關(guān).結(jié)論進(jìn)行CHD的慢性腎衰竭患者SCI的發(fā)生率增加,CHD患者的年齡,高血壓和吸煙習(xí)慣與SCI有密切關(guān)系.【關(guān)鍵詞】血液透析;腦梗塞;核磁共振成像Riskfactorsofsilentcerebralinfarctioninhe

3、modialysispatientsCHENHua—qian.HU=ANGYun-fang,LlUWei,eta1.DepartmentofNephrology,TSecondAffiliatedHospital,YunYangU-niversity,Shiyan442000,China[AbstractlObjectiveToexploretheprevalenceandriskfactorsofsilentcerebralinfarction(SCI)inhemodialysis(HD)pati

4、ents.MethodCranialmagneticresonanceimaging(MRI)wasper—formedin115HDpatientswithoutsymptomaticcerebrovasculardiseasesandin48controls.Wein—vestigatedtheincidenceofasymptomaticCIandperformedcross-sectionalstudyusingmultiplelogisticanalysistoassesstherelat

5、ionshipbetweensilentCIandtheriskfactors.ResultsTheprevalenceofa—symptomaticC1wassignificantlyhigherinHDpatientsthaninthehealthycontrolgroup(46.9VS8.3.P<0.01).Multiplelogisticregressionanalysisshowedthatindependentriskfactorsofasymp—tomaticC1werechro

6、nicrenalfailure,hypertension,smokingandage(R2=0.54,P<0.01).InCHDpatientgroup,ageandsmokingwereshowntobeindependentriskfactors(R2=0.63.P<0.01),whilenonelationofthedurationofDH.ConclusionsThefindingofthepresentstudyindicatethatchronicrenalfailureon

7、maintainencebyhemodialysisincreasestheprevalenceofasymptomaticCIandthatage,hypertensionandsmokinghabitsarealsosignificantlyassociatedwithsilentCIinHDpa—tients.[Keywords]Hemodialysis;Cerebralinfarction;Magneticresonanceimaging維持性血液透析(chronichemodialysis

8、,CHD)患者卒中的發(fā)生率明顯高于普通人群[1],多表現(xiàn)為腔隙性梗塞,高血壓是卒中的重要危險(xiǎn)因素[1].無癥狀腦梗塞(silentcerebralinfarction,SCI)是臨床皮層下腦梗塞(CI)或腦出血的潛在因素[3].大多數(shù)患者SCI表現(xiàn)為腔隙性梗塞,即皮層下梗塞最常見的形式,由細(xì)的穿通支動(dòng)脈閉塞所致的小而深的梗塞[4].腦動(dòng)脈粥樣硬化導(dǎo)致的腔隙性梗塞,與年齡和高血壓有關(guān)[5].本研究使用核磁共振(MRI),通過前瞻性臨床對(duì)照研究,探討CHD患者和健康人群S