急性缺血性脑卒中患者血尿素氮/肌酐比值变化的预后影响
Prognostic impact of blood urea nitrogen/creatinine ratio changes in patients with acute ischemic stroke.
作者信息
Jiang Wei-Feng, Deng Meng-Ling
机构信息
College of Basic Medicine, Zhejiang Chinese Medical University, Hangzhou 310053, China; Department of Neurology, The Second People's Hospital of Quzhou, Quzhou, Zhejiang 324000, China.
Department of Psychiatry, The Third Hospital of Quzhou, Quzhou, Zhejiang 324000, China.
出版信息
Clin Neurol Neurosurg. 2022 Apr;215:107204. doi: 10.1016/j.clineuro.2022.107204. Epub 2022 Mar 9.
BACKGROUND
Blood urea nitrogen (BUN)/creatinine (Cr) ratio was an independent predictor of stroke-in-evolution (SIE) among patients who had suffered an acute ischemic stroke. We investigated the association of changes in BUN/Cr on stroke outcome during hospitalization after acute ischemic stroke (AIS).
METHODS
AIS patients admitted within 3 days from stroke onset (2020-2021) were included in the study. Baseline data, including BUN and Cr levels, were collected. Univariate linear regression and a multivariate regression model were applied to assess the relationship between the change of BUN/Cr and short-term outcomes.
RESULTS
One hundred and eighty-one patients were included. The mean increase of BUN/Cr level was - 2.0 ± 1.78. Univariate linear regression suggested that baseline NIHSS, thrombolysis, change of BUN/Cr, and history of atrial fibrillation, statin use, and antiplatelet therapy was associated with the decrease in NIHSS during hospitalization (P < 0.05). After adjusting for potential confounders, multivariate regression analysis revealed the associations between the decrease in BUN/Cr and favorable outcome are significant (β = 0.21, 95% CI = 0.14,-0.28).
CONCLUSION
The decrease in BUN/Cr is positively correlated with a better early neurological improvement in AIS patients.
背景
在急性缺血性卒中患者中，血尿素氮（BUN）/肌酐（Cr）比值是进展性卒中（SIE）的独立预测因素。我们研究了急性缺血性卒中（AIS）后住院期间BUN/Cr变化与卒中结局的相关性。
方法
纳入卒中发病3天内入院的AIS患者（2020 - 2021年）。收集包括BUN和Cr水平在内的基线数据。应用单变量线性回归和多变量回归模型评估BUN/Cr变化与短期结局之间的关系。
结果
共纳入181例患者。BUN/Cr水平的平均升高为-2.0±1.78。单变量线性回归表明，基线美国国立卫生研究院卒中量表（NIHSS）评分、溶栓治疗、BUN/Cr变化以及房颤病史、他汀类药物使用和抗血小板治疗与住院期间NIHSS评分降低相关（P<0.05）。在调整潜在混杂因素后，多变量回归分析显示BUN/Cr降低与良好结局之间的关联具有显著性（β = 0.21，95%置信区间 = 0.14，-0.28）。
结论
AIS患者BUN/Cr降低与早期神经功能改善较好呈正相关。
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