摘要目的 检测急性脑梗死患者的尿白蛋白/尿肌酐比值与尿白蛋白水平,探讨其与NEW-TOAST分型的关系. 方法 收集佛山市第一人民医院神经内科自2011年3月至2012年3月收治的168例急性脑梗死患者的临床资料,另取周期体检中心体检的45例健康志愿者作为正常对照组;检测其尿白蛋白/尿肌酐比值与24 h尿白蛋白水平,并分析其相关性;比较按NEW-TOAST不同分型的脑梗死患者间及其与对照组间的尿白蛋白/尿肌酐比值与24 h尿微量白蛋白水平的差异,以及患者神经功能缺损情况(NIHSS评分)与尿白蛋白/尿肌酐比值的关系. 结果 急性脑梗死患者中尿白蛋白/尿肌酐比值与24 h尿白蛋白存在正相关关系(r=0.301,P=0.001);NEW-TOAST分型的各亚型中,大动脉粥样硬化性卒中组及小动脉闭塞性卒中组的尿白蛋白/尿肌酐比值和24 h尿白蛋白水平均明显高于对照组,差异有统计学意义(P＜0.05).脑梗死患者NIHSS评分与尿白蛋白/尿肌酐比值呈正相关关系(r=0.215,P=0.001). 结论 急性脑梗死与肾脏疾病之间存在密切关系,尿蛋白/尿肌酐比值与24h尿微量蛋白效价相当,均可成为急性脑梗死的预测及预后指标.

abstractsObjective To detect the urinary albumin level and urinary albumin/urine creatinine ratio in patients with acute cerebral infarction and explore their relations with NEW-TOAST typing.Methods One hundred and sixty-eight patients with acute cerebral infarction,admitted to our hospital from March 2011 to March 201,were chosen in our study; and other 45 healthy subjects were used as controls; according to NEW-TOAST typing,the patients were divided into different subgroups.Their clinical data were retrospectively analyzed; the 24 hour urinary albumin level and urinary albumin/urine creatinine ratio were detected and their relation was analyzed between patient group and controls,and between patients of different subtypes; besides,the correlation of neurologic impairment (NIHSS) scores with urinary albumin/urine creatinine ratio was analyzed.Results The 24 hour urinary albumin level and urinary albumin/urine creatinine ratio was positively correlated (r=0.301,P=0.001); according to the NEW-TOAST subtypes,patients with large artery atherosclerosis and small artery occlusion had significantly higher level of 24 hour urinary albumin level and urinary albumin/urine creatinine ratio (P＜0.05).NIHSS scores and urinary albumin/creatinine ratio in patient group were positively correlated (r=0.215,P=0.001).Conclusion Acute cerebral infarction and kidney disease are closely correlated;both 24 hour urinary albumin level and urinary albumin/urine creatinine ratio can be the predictor of acute cerebral infarction and influence the prognosis.