CAJ | 학술논문

目的：探讨首次发病的脑梗死合并慢性肾脏病及血钠紊乱患者的急性期及亚急性期预后关系，为临床防治提供依据。方法100例既往有慢性肾脏病病史的首次发病急性脑梗死患者，收集患者入院血钠水平、肌酐、血脂等资料进行预后关系分析，计算肾小球滤过率(eGFR)，比较患者入院时美国国立卫生研究院卒中量表评分(NIHSS)、发病后1个月改良的Rankin量表(MRS)评分及死亡率。结果 eGFR≤60 ml/(min·1.73 m2)患者具有更高的入院24 h内NIHSS评分及1个月后MRS评分；低钠血症患者的急性期及亚急性期预后均较差，发病1个月后的死亡率也较高，差异均具有统计学意义。结论合并肾功能损害与低钠血症的首次发病急性脑梗死患者短期预后较差。
목적：탐토수차발병적뇌경사합병만성신장병급혈납문란환자적급성기급아급성기예후관계，위림상방치제공의거。방법100례기왕유만성신장병병사적수차발병급성뇌경사환자，수집환자입원혈납수평、기항、혈지등자료진행예후관계분석，계산신소구려과솔(eGFR)，비교환자입원시미국국립위생연구원졸중량표평분(NIHSS)、발병후1개월개량적Rankin량표(MRS)평분급사망솔。결과 eGFR≤60 ml/(min·1.73 m2)환자구유경고적입원24 h내NIHSS평분급1개월후MRS평분；저납혈증환자적급성기급아급성기예후균교차，발병1개월후적사망솔야교고，차이균구유통계학의의。결론합병신공능손해여저납혈증적수차발병급성뇌경사환자단기예후교차。
Objective To investigate the relationship of acute stage and subacute stage prognosis of ce-rebral infraction patients complicated with chronic kidney disease and serum sodium disorders, in order to provide reference for clinical prevention and treatment. Methods There were 100 patients with cerebral infraction for the first time with medical history of chronic kidney disease. Their data of serum sodium levels, creatinine, and blood lipid were collected for prognosis analysis. Estimated glomerular filtration rate (eGFR), national institutes of health stroke scale (NIHSS) score in hospital, modified Rankin scale (MRS) score after 1 month of morbidity, and death rate were calculated. Results Patients with eGFR ≤60 ml/(min·1.73 m2) had higher scores in 24 h NIHSS and MRS after 1 month. Patients with hyponatremia had bad acute stage and subacute stage prognosis, and their death rate after 1 month of morbidity was also high. The differences all had statistical significance (P<0.05). Conclusion The cerebral infarction patients with renal impairment and hyponatremia had poor short-term prognosis.