摘要
Abstract
Objective To investigate the clinical characteristics of acute ischemic stroke (AIS) patients, and the effect of urinary albumin-to-creatinine ratio (ACR), the evaluated glomerular filtration rate (eGFR) at admission on the functional outcome at 90 days in AIS patients. Methods This was a prospective study which enrolled consecutive AIS patients who were hospitalized in Department of Neurology, Beijing Hospital from March 27, 2017 to November 16, 2017. Data of general information, vascular risk factors, ACR, eGFR, and related laboratory tests, NIHSS score on admission were collected. The outcome was evaluated by a mRS score at 3 months. Based on renal function state, all patients were divided into renal dysfunction group and normal renal function group, and the clinical characteristics between the two groups were compared. Based on the mRS at 3 months, all patients were divided into good prognosis group (mRS: 0-2) and poor prognosis group (mRS: 3-6), the clinical characteristics between the two groups were compared and independent risk factors for poor prognosis at 3 months were analyzed. Results A total of 115 patients were included in this study. The prevalence of renal dysfunction in AIS patients was 44.3% (51/115). Compared with normal renal function group, renal dysfunction group had a higher mean age (P=0.009), and higher incidence of diabetes (P=0.001), coronary heart disease (P=0.026) and atrial fibrillation (P=0.003), and a higher NIHSS score (P=0.013) on admission, and higher levels of blood glucose (P=0.001), plasma fibrinogen (P=0.008) and D-dimer (P=0.001) on admission. Compared with good prognosis group, poor prognosis group had a higher mean age (P=0.007), a higher rate of history of stroke (P=0.002), a higher incidence of atrial fibrillation (P=0.040), higher levels of plasma fibrinogen (P=0.004) and D-dimer (P<0.001), higher NIHSS (P<0.001) score on admission. There were no statistical difference in hypertension, diabetes, abnormal lipid metabolism, coronary atherosclerotic heart disease, and smoking history between the good prognosis and poor prognosis groups. Compared with the good prognosis group, the poor prognosis group had higher ACR (P<0.001) and lower eGFR (P=0.030). Multivariate analysis showed that the NIHSS score≥8 on admission ( OR 27.05, 95% CI 3.75-178.18, P=0.001), ACR≥3 mg/mmol ( OR 35.50, 95% CI 4.79-262.94, P<0.001), history of stroke ( OR 20.48, 95% CI 2.35-178.18, P=0.006) were independent risk factors for poor prognosis at 3 months. Conclusions AIS patients had a higher prevalence of renal dysfunction. The AIS patients with high ACR at admission had a poorer outcome at 3 months.关键词
急性缺血性卒中/肾功能障碍/尿白蛋白肌酐比/肾小球滤过率/预后Key words
Acute ischemic stroke/Renal dysfunction/Urinary albumin creatinine ratio/Glomerular filtration rate/Prognosis
