a Department of Neurosurgery , Renmin Hospital of Wuhan University , Wuhan , Hubei , China.
b Department of Neurology , Renmin Hospital of Wuhan University , Wuhan , Hubei , China.
Postgrad Med. 2019 Jun;131(5):342-347. doi: 10.1080/00325481.2019.1613119. Epub 2019 May 10.
: To investigate the prevalence and risk factors for microalbuminuria in patients with lacunar infarction. : 702 lacunar infarction patients and 234 controls were recruited in this study, the concentration of urinary albumin and clinical characteristics were collected for each participant. We analyzed the prevalence of microalbuminuria in lacunar infarction patients, as well as the risk factors of microalbuminuria in patients with lacunar infarction. : The prevalence of microalbuminuria in patients with lacunar infarction was 32.8%, which was significantly higher than that in controls (9.8%, ＜0.001). Multiple linear regression analysis indicated that age, alcohol abuse, fasting blood glucose, systolic blood pressure, and triglyceride were positively associated with albumin/creatinine ratio levels. Multiple logistic regression analysis indicated that age (odds ratio [OR] = 1.067, 95% confidence interval [CI] = 1.029 to 1.105), alcohol abuse (OR = 3.001, 95% CI = 1.668 to 5.398), fasting blood glucose (OR = 2.014, 95% CI = 1.794 to 2.260), and systolic blood pressure (OR = 1.033, 95% CI = 1.010 to 1.056) were the independent risk factors for microalbuminuria in acute lacunar infarction patients, with high sensitivity, specificity, positive predictive value, and negative predictive value. Receiver operating characteristic curve analysis showed that the area under the curve for age, systolic blood pressure, and fasting blood glucose were 0.618 (cutoff value, 63.5 years; sensitivity, 54.8%; and specificity, 62.9%), 0.736 (cutoff level, 149.5 mmHg; sensitivity, 78.3%; and specificity, 61.2%) and 0.893 (cutoff value, 7 mmol/L; sensitivity, 92.2%; and specificity, 86%), respectively. : Lacunar infarction was associated with higher microalbuminuria prevalence. Age, alcohol abuse, fasting blood glucose, and systolic blood pressure were individually significant and correlated factors of microalbuminuria in patients with lacunar infarction. More attention should be provided to this group of patients.
探讨腔隙性脑梗死患者微量白蛋白尿的患病率及相关危险因素。
本研究共纳入 702 例腔隙性脑梗死患者和 234 例对照者，收集每位参与者的尿白蛋白浓度和临床特征。我们分析了腔隙性脑梗死患者微量白蛋白尿的患病率，以及腔隙性脑梗死患者微量白蛋白尿的危险因素。
腔隙性脑梗死患者微量白蛋白尿的患病率为 32.8%，显著高于对照组（9.8%，＜0.001）。多线性回归分析表明，年龄、酗酒、空腹血糖、收缩压和甘油三酯与白蛋白/肌酐比值水平呈正相关。多因素 logistic 回归分析表明，年龄（比值比[OR] = 1.067，95%置信区间[CI] = 1.029 至 1.105）、酗酒（OR = 3.001，95%CI = 1.668 至 5.398）、空腹血糖（OR = 2.014，95%CI = 1.794 至 2.260）和收缩压（OR = 1.033，95%CI = 1.010 至 1.056）是急性腔隙性脑梗死患者微量白蛋白尿的独立危险因素，具有较高的灵敏度、特异性、阳性预测值和阴性预测值。受试者工作特征曲线分析显示，年龄、收缩压和空腹血糖的曲线下面积分别为 0.618（截断值 63.5 岁；灵敏度 54.8%，特异性 62.9%）、0.736（截断值 149.5mmHg；灵敏度 78.3%，特异性 61.2%）和 0.893（截断值 7mmol/L；灵敏度 92.2%，特异性 86%）。
腔隙性脑梗死与更高的微量白蛋白尿患病率相关。年龄、酗酒、空腹血糖和收缩压是腔隙性脑梗死患者微量白蛋白尿的独立且相关的危险因素。应更加关注这组患者。
