Silent cerebral infarction in hemodialysis patients
Silent cerebral infarction in hemodialysis patients
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DOI：
10.1159/000068034
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发表时间：
2003-03-01
影响因子：
4.2
通讯作者：
Sugimura, K
中科院分区：
文献类型：
--
作者：
Nakatani, T;Naganuma, T;Sugimura, K
背景脑血管疾病在血液透析（HD）患者中非常常见。无症状性脑梗死（SCI）虽然可能是脑血管疾病的一个重要危险因素，但尚未在HD患者中进行研究。假设：慢性肾功能衰竭可能是SCI和脑血管病的独立危险因素。研究方法：对123名无症状性脑血管疾病的HD患者和52名对照受试者进行了头颅磁共振成像（MRI）。我们调查了脊髓损伤的患病率，并进行了横断面研究，使用多因素Logistic分析来评估脊髓损伤与危险因素之间的关系。结果如下：HD患者的SCI患病率显著高于健康对照组（60例患者（48.8%）vs. 5例患者（9.6%），chi（2）= 22.4，p < 0.0001）。多因素Logistic回归分析显示，慢性肾功能衰竭、高血压、吸烟和年龄是SCI的独立危险因素（R-2 = 0.468，p < 0.0001）。仅在HD患者组中，年龄和吸烟被证明是SCI的独立危险因素（R-2 = 0.378，p < 0.0001），而HD持续时间和高血压不是。结论：本研究的结果表明，血液透析维持的慢性肾功能衰竭增加了SCI的患病率，并且年龄和吸烟习惯也与HD患者的SCI显著相关。版权所有（C）2003 S. Karger AG，巴塞尔。
Background. Cerebrovascular diseases are very common in hemodialysis (HD) patients. Silent cerebral infarction (SCI) has not been investigated in HD patients although it may be a significant risk factor for cerebrovascular diseases. Hypothesis: Chronic renal failure may be an independent risk factor for SCI and cerebrovascular diseases. Methods: Cranial magnetic resonance imaging (MRI) was performed on 123 HD patients without symptomatic cerebrovascular disease and on 52 control subjects. We investigated the prevalence of SCI and performed cross-sectional study using multiple logistic analysis to assess the relationship between SCI and the risk factors. Results: The prevalence of SCI was significantly higher in HD patients than in the healthy control group (60 patients (48.8%) vs. 5 patients (9.6%), chi(2) = 22.4, p < 0.0001). Multiple logistic regression analysis with all subjects showed that independent risk factors of SCI were chronic renal failure, hypertension, smoking and age (R-2 = 0.468, p < 0.0001). In only the HD patient group, age and smoking were shown to be independent risk factors of SCI (R-2 = 0.378, p < 0.0001) while HD duration and hypertension were not. Conclusions: The findings of the present study indicate that chronic renal failure maintained by hemodialysis increases the prevalence of SCI and that age and smoking habits are also significantly associated with SCI in HD patients. Copyright (C) 2003 S. Karger AG, Basel.