摘要
目的研究脑卒中并发急性肾功能衰竭(急性肾衰)与高渗透压血症的相关性及有关因素.方法总结59例脑卒中并发急性肾衰患者(急性肾衰组)和76例肾功能正常的脑卒中患者(对照组)的临床资料.将两组患者的血浆渗透压与血清肌酐值进行相关分析.用Logistic回归分析确定脑卒中并发急性肾衰的有关因素.结果平均血浆渗透压急性肾衰组[(320.98±30.63)mOsm/L]明显高于对照组[(295.49±17.7)mOsm/L](P＜0.001).平均血清肌酐急性肾衰组[(298.15±94.72)μmol/L]明显高于对照组[(93.47±33.34)μmol/L](P＜0.001).两组患者的血浆渗透压与肌酐均呈正相关(r=0.452,P＜0.001).多因素分析显示,高渗透压血症(OR=4.40,95%CI=1.91～10.14)、全身炎症反应综合征(SIRS)3～4级(OR=4.58,95%CI=2.01～10.43)、静滴甘露醇(OR=8.88,95%CI=1.74～45.27)与脑卒中患者急性肾衰有关联.结论血浆渗透压升高与脑卒中并发急性肾衰有密切关系.高渗透压血症、SIRS 3～4级和静滴甘露醇是脑卒中并发急性肾衰的联合因素或独立因素.
Objective To study the relationship between acute renal failure （ARF） and hyperosmolaremia in stroke patients and the related faeton. Methods The clinical data of 59 stroke patients with ARF （ARF group） and 76 stroke patients without ARF （control group） were studied. The correlation analysis was used to compare the serum osmolality levels and serum creatinine values between the two groups. The factors that caused ARF in stroke patients were estimated using a logistic regression model. Results The mean serum osmolality in ARF group[ （320. 98 ± 30. 63） mOsnr/L] was significantly higher than that in control group [ （295.49 ± 17.7 ） mOsnr/L] （ P 〈 0. 001 ）. The mean serum creatinine in ARF group[ （298. 15 ±94. 72）Ixmol/L] was significantly higher when compared with the control group[ （93.47 ± 33.34） μmol/L （ P 〈 0. 001 ）. There was a positive correlation （ r = 0. 452, P 〈 0. 001 ） between serum osmolality and serum ereatinine in the two groups. Multiple factors analysis showed that hyperosmloremia （OR =4.4, 95% CI = 1.91±10. 14） , SIRS 3 - 4 （ OR = 4. 58, 95% CI = 2. 01±10. 34） and therapy of mannitol （ OR = 8.88, 95% CI = 1.74±45.27 ） were associated with ARF in stroke patients. Conclusion Increase of serum osmolality is associated with acute renal failure. Multiple factors such as hyperosmolaremia, SIRS 3 ～ 4 and therapy of mannitol are the combined or independent risk factors of acute renal failure in stroke patients.
出处
《临床神经病学杂志》
CAS
北大核心
2005年第5期338-340,共3页
Journal of Clinical Neurology
