急性缺血性中风患者的肾功能损害和脑微出血

Impaired kidney function and cerebral microbleeds in patients with acute ischemic stroke.

作者信息

Cho A-H, Lee S B, Han S J, Shon Y-M, Yang D-W, Kim B S

机构信息

Department of Neurology, The Catholic University of Korea, St Mary's Hospital, Young-dung-PO Gu, Seoul 150-713, South Korea.

出版信息

Neurology. 2009 Nov 17;73(20):1645-8. doi: 10.1212/WNL.0b013e3181c1defa.

DOI:10.1212/WNL.0b013e3181c1defa

PMID:19917986

Abstract

BACKGROUND

We investigated the association between the presence of cerebral microbleeds and poor kidney function in patients with acute ischemic stroke.

METHODS

We retrospectively examined consecutive acute ischemic stroke patients who underwent gradient echo MRI. The presence of cerebral microbleeds on gradient echo MRI was independently interpreted. The number and location of microbleeds were assessed. Demographics including age, sex, risk factors, and stroke subtype were obtained. Kidney function was estimated by measuring glomerular filtration rate (GFR) with the modification of diet in renal disease method.

RESULTS

Of the 152 patients included, 45 (29.6%) patients had cerebral microbleeds on gradient echo MRI. The cerebral microbleeds were most commonly located in deep or infratentorial location (27/45 [60%]). Hypertension, presence of leukoaraiosis, old age, and low GFR were associated with the presence of cerebral microbleeds (p = 0.064, <0.001, 0.014, and <0.001). The mean GFR levels were lower in patients with cerebral microbleeds (65.15 +/- 22.54 vs 78.82 +/- 19.11 mL/min/1.73 m(2)). After the adjustment of risk factors, age, and sex, low GFR levels were associated with the presence of cerebral microbleeds (odds ratio, 3.85; 95% confidence interval, 1.52 to 9.76, p = 0.004).

CONCLUSION

Impaired kidney function is associated with the presence of cerebral microbleeds in acute ischemic stroke.

摘要

背景

我们研究了急性缺血性卒中患者脑微出血的存在与肾功能不佳之间的关联。

方法

我们回顾性检查了连续接受梯度回波MRI的急性缺血性卒中患者。独立解读梯度回波MRI上脑微出血的存在情况。评估微出血的数量和位置。获取包括年龄、性别、危险因素和卒中亚型在内的人口统计学信息。采用肾病饮食改良法测量肾小球滤过率（GFR）来评估肾功能。

结果

纳入的152例患者中，45例（29.6%）在梯度回波MRI上有脑微出血。脑微出血最常见于深部或幕下部位（27/45 [60%]）。高血压、白质疏松症的存在、老年和低GFR与脑微出血的存在相关（p = 0.064、<0.001、0.014和<0.001）。有脑微出血的患者平均GFR水平较低（65.15±22.54 vs 78.82±19.11 mL/min/1.73 m²）。在调整危险因素、年龄和性别后，低GFR水平与脑微出血的存在相关（比值比，3.85；95%置信区间，1.52至9.76，p = 0.004）。