中国血液净化

中国血液净化 ›› 2014, Vol. 13 ›› Issue (02): 70-73.doi: 10.3969/j.issn.1671-4091.2014.02.002

• 临床研究 • 上一篇    下一篇

腹膜透析患者并发脑卒中危险因素的临床分析

宋海英,何永成,万启军,栾韶东   

  1. 深圳市第二人民医院肾内科
  • 收稿日期:2013-09-13 修回日期:2013-10-27 出版日期:2014-02-12 发布日期:2014-02-12
  • 通讯作者: 何永成 heyongcheng@medmail.com.cn E-mail:heyongcheng@medmail.com.cn
  • 基金资助:

    深圳市科技研发资金项目(项目编号JCYJ20130401110433244)

Retrospective Analysis of Risk Factors for Stroke in Peritoneal Dialysis Patients

  • Received:2013-09-13 Revised:2013-10-27 Online:2014-02-12 Published:2014-02-12

RichHTML

0

PDF

264

摘要： 目的 探讨腹膜透析患者脑卒中的危险因素。方法 回顾性分析2005年1月至2012年1月深圳市第二人民医院肾内科122例腹膜透析患者的临床资料。将患者分为两组：合并脑卒中的患者（A组，n=17）和无并发脑卒中的患者（B组，n=105）。统计腹膜透析患者脑卒中的发生率。观察并比较两组患者血清CRP水平、同型半胱氨酸浓度、血清尿酸浓度的差异。分析年龄、腹透龄、高血压、糖尿病、同型半胱氨酸浓度、血清C反应蛋白（CRP）水平、血清尿酸浓度、血清N末端脑钠肽前体（BNP）等指标与腹膜透析患者发生脑卒中的相关性。结果 本组患者共发生脑卒17例，发生率为13.9%，其中男性13例（76.5%），女性4例（23.5%）。60岁以上患者发生脑卒中者共11例（64.7%），60及岁以下患者发生脑卒中为6例（35.3%），A组患者平均年龄63.5±10.7岁，B组患者平均年龄52.7±14.9岁，A组患者年龄大于B组患者年龄，差异有统计学意义（P＜0.05﹚。血清CRP水平A组（30.1±21.7mg/l）高于B组（12.1±13.3mg/l）、血同型半胱氨酸浓度A组（19.6±4.8umol/l）高于B组（14.8±6.9umol/l），差异有统计学意义（P<0.05）。血清尿酸浓度A组（340.4±71.0umol/l）低于B组（418.4±119.1umol/l），差异有统计学意义（P=0.01）。多因素非条件Logistic回归分析显示高血压（P=0.026），糖尿病（P=0.022)，CRP（P=0.001)，BNP（P=0.045)，血清同型半胱氨酸（P=0.017)均为腹膜透析患者发生脑卒中的危险因素。结论 本组腹膜透析患者脑卒中发生率为13.9%。高血压、糖尿病、高CRP浓度、高同型半胱氨酸浓度均是腹膜透析患者发生脑卒中的独立危险因素。

关键词: 腹膜透析, 脑卒中, 回顾性研究

Abstract: ［Objective］: To Explore risk factors for stroke in peritoneal dialysis patients in single dialysis center. ［Methods］: Clinical data of 122 peritoneal dialysis patients admitted from January 2005 to January 2012 in Shenzheng 2nd people’s hospital were collected and retrospectively analyzed. Totally 17 cases were confirmed with stroke (group A, n=17) and the other 115 patients were not (group B, n=105). Correlational analyses between stroke and age, peritoneal dialysis duration, KT/V, hypertension, diabetes, homocysteine concentration, serum CRP levels, serum uric acid concentration,BNP were conducted. ［Results］Stroke was found in 17 (13.9%) cases of the analysis group which included 13 males(76.5%) and 4 females (23.5%) , in which hemorrhagic stroke were confirmed in 3 cases and ischemic stroke in other 14 cases. 11 patients with stroke were found aged over 60 (64.7%), only 6 cases with stroke were less than 60 years old （35.3%）.The A group of patients with an average age of 63.5±10.7 years, The B group of patients with an average age of 52.7±14.9 years, The A group of patients older than The B group of patients (P<0.05). The level of serum CRP and homocysteine concentration in group A was significantly higher than that in group B (P<0.05). Serum uric acid concentration in group A （340.4±71.0umol/l） was significantly lower than that in group B （418.4±119.1umol/l）, (P=0.01). Multivariate unconditional logistic regression analysis showed that hypertension（P=0.026）, diabetes（P=0.022), high level of serum CRP（P=0.001), high BNP concentration（P=0.045) ,high homocysteine concentration（P=0.017) were independent risk factors for stroke in peritoneal dialysis patients. ［Conclusion］: The incidence of stroke in our peritoneal dialysis patients was 13.9%. Hypertension, diabetes, high serum CRP level, high homocysteine concentration were independent risk factors for stroke in peritoneal dialysis patients.

Key words: Peritoneal dialysis, Stroke, Retrospective study