摘要
目的探讨肾小球滤过率(eGFR)与非瓣膜性房颤致心源性卒中老年患者长期不良预后的关系。方法纳入2013年1月-2016年1月于首都医科大学宣武医院神经内科住院的非瓣膜性房颤致心源性卒中老年患者195例(年龄≥65岁),使用肾脏病饮食改良(MDRD)简化公式计算肾小球滤过率估计值(eGFR),按照eGFR<60ml/(min·1.73m^2)为肾功能不全,分为肾功能不全组(34例)和无肾功能不全组(161组),出院后1年通过电话或门诊随访,观察卒中不良结局,包括全因死亡、卒中复发、联合终点事件(卒中或死亡)、卒中性残疾。结果(1)肾功能不全组(eGFR<60ml/min·1.73m^2)患者中,年龄≥75岁者的比例高于无肾功能不全组[eGFR≥60ml/(min·1.73m^2)]患者,差异有统计学意义(85.3%(29/34)比54.0%(87/161),P<0.05);(2)肾功能不全组和无肾功能不全组比较,出院后1年不良预后结局事件发生率的差异有统计学意义(52.9%比32.9%,χ^2=4.860,P=0.027<0.05);(3)多因素Logistic分析显示,非瓣膜性房颤致心源性卒中老年患者1年内发生卒中不良结局事件与患者出院时NIHSS有关(OR=1.141,P<0.05)。结论患者出院时NIHSS评分可以预测非瓣膜性房颤致心源性卒中老年患者长期不良预后结局,与患者eGFR低于60ml/(min·1.73m^2)无关。
Objective To discuss the correlation between estimating glomerular filtration rate(eGFR)and long-term poor prognosises of elderly patients with Cardioembolic Stroke caused by non-valvular atrial fibrillation.Methods Totals of 195 elderly patients(age≥65)of Cardioembolic Stroke caused by non-valvular atrial fibrillation in Neurology Department,Xuan Wu Hospital between January 2013and January 2016were included.Estimated glomerular filtration rate(eGFR)was estimated by revised Modification of Diet in Renal Disease(MDRD)equation.Renal inadequacy is defined as eGFR<60ml/(min·1.73m^2).There were 34cases in renal inadequacy group and 161cases in renal adequacy group.The followed-up duration lasted for 1year.The association between eGFR and poor stroke outcomes was evaluated by multivariate analysis.Results(1)The proportion of patients older than 75years in renal inadequacy group was bigger than renal adequacy group[85.3%(29/34)vs.54.0%(87/161),P<0.05].(2)There was statistical difference between renal inadequacy group and renal adequacy group on rate of outcome events(52.9%vs.32.9%,χ^2=4.860,P=0.027<0.05).(3)Multivariate logistic regression analysis showed that NIHSS after the hospital was the risk factors for the occurrence of endpoint events within 1year after Cardioembolic Stroke(OR=1.752,P<0.05;OR=1.141,P<0.05).Conclusion NIHSS after the hospital was the predictive factor for the occurrence of endpoint events in elderly patients with Cardioembolic Stroke caused by non-valvular atrial fibrillation.The incidence was independent of glomerular filtration rate[eGFR<60ml/(min·1.73m^2)].
作者
董恺
王媛
俞志鹏
丁建平
张倩
黄小钦
宋海庆
DONG Kai;WANG Yuan;YU Zhi-peng(Department of Neurology,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)
出处
《中国实验诊断学》
2019年第11期1869-1872,共4页
Chinese Journal of Laboratory Diagnosis
基金
国家自然科学基金(81801142)
关键词
肾小球滤过率
心源性卒中
预后
老年
Estimated glomerular filtration rate
Cardioembolic Stroke
prognosis
elderly patients
