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1、血液透析患者无症状脑梗塞危险因素的探讨2006年12月第6卷第6期JClinNephrolDecember2006,Vo1.6,No.6血液透析患者无症状脑梗塞危险因素的探讨陈华茜黄云芳刘巍杨涛赵黎黄光敏【摘要】目的探讨维持性血液透析(CHD)患者发生无症状脑梗塞(SCI)的危险因素.方法对无脑血管疾病症状的115例CHD患者和48例尿毒症非透析患者进行头颅核磁共振成像(MRI)检查,研究SCI的发生率,并使用多元回归分析,探讨CHD患者SCI的危险因素.结果CHD患者SCI的发生率显着高于对照组(
2、分别是46.9,8.3,P<O.叭).对所有受试者进行多元回归分析的结果表明,SCI的危险因素包括:慢性肾衰竭,高血压,吸烟和年龄(R2=0.54,P<0.01).在CHD组,年龄和吸烟是独立危险因素(R2=0.63,P<0.【)1),而与CHD持续时间无关.结论进行CHD的慢性肾衰竭患者SCI的发生率增加,CHD患者的年龄,高血压和吸烟习惯与SCI有密切关系.【关键词】血液透析;脑梗塞;核磁共振成像Riskfactorsofsilentcerebralinfarctioninhe
3、modialysispatientsCHENHua—qian.HU=ANGYun-fang,LlUWei,eta1.DepartmentofNephrology,TSecondAffiliatedHospital,YunYangU-niversity,Shiyan442000,China[AbstractlObjectiveToexploretheprevalenceandriskfactorsofsilentcerebralinfarction(SCI)inhemodialysis(HD)pati
4、ents.MethodCranialmagneticresonanceimaging(MRI)wasper—formedin115HDpatientswithoutsymptomaticcerebrovasculardiseasesandin48controls.Wein—vestigatedtheincidenceofasymptomaticCIandperformedcross-sectionalstudyusingmultiplelogisticanalysistoassesstherelat
5、ionshipbetweensilentCIandtheriskfactors.ResultsTheprevalenceofa—symptomaticC1wassignificantlyhigherinHDpatientsthaninthehealthycontrolgroup(46.9VS8.3.P<0.01).Multiplelogisticregressionanalysisshowedthatindependentriskfactorsofasymp—tomaticC1werechro
6、nicrenalfailure,hypertension,smokingandage(R2=0.54,P<0.01).InCHDpatientgroup,ageandsmokingwereshowntobeindependentriskfactors(R2=0.63.P<0.01),whilenonelationofthedurationofDH.ConclusionsThefindingofthepresentstudyindicatethatchronicrenalfailureon
7、maintainencebyhemodialysisincreasestheprevalenceofasymptomaticCIandthatage,hypertensionandsmokinghabitsarealsosignificantlyassociatedwithsilentCIinHDpa—tients.[Keywords]Hemodialysis;Cerebralinfarction;Magneticresonanceimaging维持性血液透析(chronichemodialysis
8、,CHD)患者卒中的发生率明显高于普通人群[1],多表现为腔隙性梗塞,高血压是卒中的重要危险因素[1].无症状脑梗塞(silentcerebralinfarction,SCI)是临床皮层下脑梗塞(CI)或脑出血的潜在因素[3].大多数患者SCI表现为腔隙性梗塞,即皮层下梗塞最常见的形式,由细的穿通支动脉闭塞所致的小而深的梗塞[4].脑动脉粥样硬化导致的腔隙性梗塞,与年龄和高血压有关[5].本研究使用核磁共振(MRI),通过前瞻性临床对照研究,探讨CHD患者和健康人群S
