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PLoS One:卒中患者蛋白尿与未来心血管事件和死亡发生相关

2016-06-08 phylis 译 MedSci原创

背景:估计肾小球滤过率(eGFR)和蛋白尿与缺血性脑卒中的预后相关。在这项研究中,研究者调查一个卒中队列中,eGFR和蛋白尿与死亡率,血管事件和功能预后的纵向关系。方法:2012年5月到2015年2月,共招募缺血性卒中患者295例。肾功能障碍为eGFR下降(<60mL/min/ 1.73m2)或蛋白尿(尿白蛋白/肌酐比值≥30mg/g)。6个月良好的功能预后为改良Rankin量表评分≤2,监测主要

背景:估计肾小球滤过率(eGFR)和蛋白尿与缺血性脑卒中的预后相关。在这项研究中,研究者调查一个卒中队列中,eGFR和蛋白尿与死亡率、血管事件和功能预后的纵向关系。

方法:2012年5月到2015年2月,共招募缺血性卒中患者295例。肾功能障碍为eGFR下降(<60mL/min/ 1.73m2)或蛋白尿(尿白蛋白/肌酐比值≥30mg/g)。6个月良好的功能预后为改良Rankin量表评分≤2,监测主要血管事件的发生(卒中、急性冠脉综合征或外周动脉闭塞)或死亡。应用Cox比例风险模型和Logistic回归分析肾功能不全与死亡率,主要血管事件和6个月的功能预后的相关性。获得校正和未校正的危险比(HR),比值比(OR),95% CI。根据是否存在蛋白尿,获得复合不良事件(主要心血管事件或死亡)Kaplan-Meier生存曲线。

结果:多变量Cox比例风险中,校正年龄、性别、糖尿病、高血压、吸烟、房颤、既往脑卒中、饮酒史,国立卫生院卒中量表(NIHSS)初始评分和eGFR后,蛋白尿与死亡率(HR 2.15;95% CI 1.09-4.25)和主要血管事件(HR 2.24;95% CI 1.02-4.94)显著相关。在多因素Logistic回归分析中,校正年龄,性别,糖尿病、高血压、吸烟、房颤、既往脑卒中、饮酒史和eGFR后,蛋白尿和6个月功能预后负相关(0.36;95% CI 0.20-0.65),但校正NIHSS分数后,这种相关性消失(0.79;95% CI 0.39-1.60; P = 0.519)。与无蛋白尿的患者相比,蛋白尿的患者复合不良事件发生率显著升高。

结论:在评估缺血性卒中患者未来心血管事件和死亡的发生中,蛋白尿似乎是比eGFR更有用的临床指标。

原始出处:

Lee SJ, Lee DG. Relationship between Kidney Dysfunction and Ischemic Stroke Outcomes: Albuminuria, but Not Estimated Glomerular Filtration Rate, Is Associated with the Risk of Further Vascular Events and Mortality after Stroke. PLoS One. 2016 May 23.


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    2016-10-12 ylzr123

    学习了,好文值得点赞!

    0

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    2016-06-10 微分

    蛋白尿,有想法

    0

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背景:颅内动脉粥样硬化性狭窄(ICAS)是脑卒中的常见原因,但是对其流行病学的了解较少。研究者在美国心血管队列中,应用高分辨率磁共振血管造影研究ICAS与血管危险因素的相关性。方法:社区动脉粥样硬化风险研究(ARIC)在1987到1989年间从4个美国社区招募受试者。采用分层抽样的方法,研究者从visit5选出1980名受试者进行高分辨率3T磁共振血管造影。所有的图像在一个中心实验室分析,ICAS

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