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慢性肾脏病与颈动脉粥样硬化及症状性缺血性卒中相关。

Chronic kidney disease is associated with carotid atherosclerosis and symptomatic ischaemic stroke.

作者信息

Kajitani Nobuo, Uchida Haruhito A, Suminoe Isao, Kakio Yuki, Kitagawa Masashi, Sato Hajime, Wada Jun

机构信息

1 Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.

2 Department of Chronic Kidney Disease and Cardiovascular Disease, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.

出版信息

J Int Med Res. 2018 Sep;46(9):3873-3883. doi: 10.1177/0300060518781619. Epub 2018 Jul 3.

Abstract

Objective We aimed to investigate the relationships among chronic kidney disease (CKD), symptomatic ischaemic stroke, and carotid atherosclerosis. Methods We enrolled 455 patients who underwent carotid ultrasonography in our hospital, including 311 patients with symptomatic ischaemic stroke and 144 patients without symptomatic ischaemic stroke. Carotid intima-media thickness (IMT), the rate of internal carotid artery stenosis, and maximal plaque size were evaluated. Results The mean age of the patients was 68.5 ± 11.0 years and the mean estimated glomerular filtration rate (eGFR) was 68.8 ± 18.2 mL/min/1.73 m. After adjustment for cardiovascular risk factors, the mean IMT was significantly higher in patients with CKD than in those without CKD. The IMT and eGFR were negatively correlated in patients with stroke (r = -0.169). Multiple logistic regression analyses showed that mean IMT, plaque size, and internal carotid artery stenosis were significant determinants of symptomatic ischaemic stroke after adjustment of multivariate risk factors. Furthermore, the eGFR was a negative determinant of symptomatic ischaemic stroke after adjusting for classical risk factors (odds ratio [95% confidence interval] = 0.868 [0.769-0.979]). Conclusion CKD might be associated with the carotid atherosclerosis and symptomatic ischaemic stroke.

摘要

目的 我们旨在研究慢性肾脏病(CKD)、症状性缺血性卒中与颈动脉粥样硬化之间的关系。方法 我们纳入了在我院接受颈动脉超声检查的455例患者,其中包括311例症状性缺血性卒中患者和144例无症状性缺血性卒中患者。评估颈动脉内膜中层厚度(IMT)、颈内动脉狭窄率和最大斑块大小。结果 患者的平均年龄为68.5±11.0岁,平均估算肾小球滤过率(eGFR)为68.8±18.2 mL/min/1.73 m²。在调整心血管危险因素后,CKD患者的平均IMT显著高于无CKD的患者。卒中患者的IMT与eGFR呈负相关(r = -0.169)。多因素logistic回归分析显示,在调整多变量危险因素后,平均IMT、斑块大小和颈内动脉狭窄是症状性缺血性卒中的重要决定因素。此外,在调整经典危险因素后,eGFR是症状性缺血性卒中的负向决定因素(比值比[95%置信区间]=0.868[0.769 - 0.979])。结论 CKD可能与颈动脉粥样硬化和症状性缺血性卒中相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/42e5/6136003/1025266bed45/10.1177_0300060518781619-fig1.jpg

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