CAJ | 학술논문

[目的]探讨急性脑卒中患者TOAST分型与慢性肾功能不全（CRI）的关系。[方法]回顾性分析2010年10月至2012年10月本院566例首次入院的急性脑卒中患者的临床资料，比较非CRI患者与合并CRI者在TOAST分型、病灶影像学分布和神经功能缺损程度方面的差异。[结果]566例脑卒中患者中有168例合并CRI者（29．7％）。其中，大动脉闭塞型（LAA ）和心源性栓塞型（CE），在合并CRI组中的比例（42．26％和13．10％）明显高于非CRI患者（22．36％和6．01％）（ P ＜0．05）；小动脉粥样硬化型（SAA）和不明原因型（SUE）在合并CRI患者组中存在比例显著低于非CRI组（ P ＜0．05），差异具有统计学意义；急性脑卒中合并CRI患者非底节区和后循环梗死发生率（42．86％，22．41％）明显高于非 CRI患者（21．87％，11．05％）；底节区梗死率（11．90％）明显低于非CRI患者（36．88％），有显著性差异（ P ＜0．05）；脑卒中合并CRI患者神经功能缺损程度显著低于非CRI患者（ P ＜0．05）。[结论]TOAST 分型可以对急性脑卒中患者是否合并CRI进行初步预判，有助于进行更为深入的诊断及早期干预。
[목적]탐토급성뇌졸중환자TOAST분형여만성신공능불전（CRI）적관계。[방법]회고성분석2010년10월지2012년10월본원566례수차입원적급성뇌졸중환자적림상자료，비교비CRI환자여합병CRI자재TOAST분형、병조영상학분포화신경공능결손정도방면적차이。[결과]566례뇌졸중환자중유168례합병CRI자（29．7％）。기중，대동맥폐새형（LAA ）화심원성전새형（CE），재합병CRI조중적비례（42．26％화13．10％）명현고우비CRI환자（22．36％화6．01％）（ P ＜0．05）；소동맥죽양경화형（SAA）화불명원인형（SUE）재합병CRI환자조중존재비례현저저우비CRI조（ P ＜0．05），차이구유통계학의의；급성뇌졸중합병CRI환자비저절구화후순배경사발생솔（42．86％，22．41％）명현고우비 CRI환자（21．87％，11．05％）；저절구경사솔（11．90％）명현저우비CRI환자（36．88％），유현저성차이（ P ＜0．05）；뇌졸중합병CRI환자신경공능결손정도현저저우비CRI환자（ P ＜0．05）。[결론]TOAST 분형가이대급성뇌졸중환자시부합병CRI진행초보예판，유조우진행경위심입적진단급조기간예。
[Objective]To explore the relationship between TOAST classification and chronic renal insuffi-ciency(CRI) in patients with acute stroke .[Methods]Clinical data of 566 patients with acute stroke treated in our hospital from Oct .2010 to Oct .2012 were analyzed retrospectively .The difference in TOAST classifica-tion ,distribution of lesions and nerve function defect between non-CRI patients and CRI patients was com-pared .[Results]Of 566 stroke patients ,168 patients were complicated with renal insufficiency (29 .7% ) .The proportion of large arterial occlusion (LAA) patients and cardiogenic embolism (CE) patients in CRI group (42 .26% and 13 .10% ,respectively ) was obviously higher than that in non-CRI group(22 .36% and 6 .01% , respectively)( P <0 .05) ,and the proportion of small arterial atherosclerosis(SAA) patients and patients with unexplained origin(SUE) in CRI group was markedly lower than that in non-CRI group ,and there was signifi-cant difference( P<0 .05) .The incidence of infarction at non-bottom section area and the posterior circulation in CRI group(42 .86% and 22 .41% ,respectively) was obviously higher than that in non-CRI group(21 .87%and 11 .05% ,respectively) .The incidence of infarction at bottom section area in CRI group (11 .90% ) was ob-viously lower than that in non-CRI patients(36 .88% ) ,and there was significant difference( P <0 .05) .The degree of neurological deficit in CRI group was significantly lower than that in non-CRI group( P < 0 .05) .[Conclusion] TOAST classification can preliminary predict the patients complicated with or without CRI ,and is helpful for further diagnosis and early intervention .