Patients who initiated peritoneal dialysis (PD) in Sichuan Provincial People's Hospital from January 1, 2001 to December 31, 2013 were enrolled in the single center and retrospective study. Clinical and laboratory data were collected to analyze the long-term survival rates, technique survival rates and associated influencing factors. Patients were followed up until December 31, 2021 or endpoints occurred (death or stopping PD treatment). Kaplan-Meier survival curves were used to estimate survival rates and technique survival rates. Cox proportional hazards regression model was used to analyze the risk factors of death and technique failure in PD patients. A total of 373 patients were enrolled in the study, with age of (52.1±15.8) years old and 199 (53.4%) males. During the follow-up, 154 (41.3%) patients died, 72 (19.3%) patients transferred to hemodialysis, and 40 (10.7%) patients received kidney transplant. Kaplan-Meier survival curves revealed that overall survival rates of PD patients at 1, 3, 5, 7, and 10 years were 92.2%, 76.6%, 66.0%, 52.4% and 38.6%, respectively. Technique survival rates were 93.5%, 84.8%, 74.2%, 62.8% and 44.5% at 1, 3, 5, 7, and 10 years, respectively. Multivariate Cox regression model results showed that age ( HR=1.055, 95% CI 1.039-1.073, P<0.001), transfer from hemodialysis ( HR=2.212, 95% CI 1.514-3.231, P<0.001), episodes of peritonitis ( HR=2.141, 95% CI 1.194-3.837, P=0.011), Charlson comorbidity index ( HR=1.525, 95% CI 1.305-1.783, P<0.001), and baseline albumin ( HR=0.951, 95% CI 0.925-0.978, P<0.001) were independent influencing factors of survival in PD patients. Episodes of peritonitis ( HR=2.327, 95% CI 1.274-4.250, P=0.006) and Charlson comorbidity index ( HR=1.244, 95% CI 1.035-1.496, P=0.020) were independent influencing factors of technique survival in PD patients. PD patients have good early survival rates and technical survival rates, but long-term outcomes need to be further improved. Peritonitis is a major risk factor for low long-term survival rates and technical survival rates in PD patients.

急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)是严重威胁生命的呼吸衰竭形式之一,是由多种肺内和肺外致病因素导致的一种以呼吸窘迫和难治性低氧血症为主要特征,导致呼吸衰竭的综合征,发展快、起病急,如不及时救治,并发症和死亡发生率极高,临床上需高度重视.

目的 探讨血液透析(HD)患者、腹膜透析(PD)患者及健康者肠道菌群的变化.方法 收集36例HD患者、27例PD患者及57例健康对照者的粪便,采用16SrRNA测序,评估其粪便微生物群组成的差异.结果 与对照组比较,PD组、HD组患者肠道菌群总数显著降低(P<0.01).PD组与对照组、HD组与对照组之间的chao指数比较,差异有统计学意义(P<0.001),HD组与对照组群落多样性差异有统计学意义(P<0.01),对照组的群落多样性更高.普雷沃特拉菌水平与透析患者生存时间呈负相关(P=0.04).结论 PD、HD患者的肠道菌群发生了改变,HD患者的肠道菌群变化较PD患者更为显著.

Objective:To investigate the effect of Shenghua decoction combined with misoprostol for treating women with retained products of conception（RPOC） after natural delivery.Methods:210 women with RPOC（excluding placenta accreta） after natural delivery of term pregnancy were randomly divided into three groups（70 cases in each group）.The women in group A were given puerperal health education,the women in group B were given puerperal health education and oral misoprostol treatment,and the women in group C were given Shenghua Decoction combined with misoprostol treatment except to the puerperal health education.The clinical effect of the women in the three groups was observed.Results:There were significant differences in the total effective rate（65.2%,80.3%,and90.8%） and the total curettage rate（28.8%,19.7%,and 10.7%） of the women among group A,group B,and group C（all P＜0.05）.The bleeding time during treatment,the proportion of maximum vaginal bleeding equal to or more than menstrual volume,the sum value of the three diameters of uterus by transvaginal ultrasound in the postpartum42d,the time of menstrual recovery,the number of menstruations before recovery of the regular menstrual cycle,and the rate of menstrual volume reduction of the women in group C,in group B,and in group A had increased gradually.The menstrual days of the women in group C,in group B,and in group A had decreased gradually（all P＜0.05）.The number of menstrual cycles before the recovery of the regular menstrual cycle of the women in group A had significant different from that of the women in group B and that of the women in group C（P＜0.05）,while which of the women in group B had no significant different from that of the women in group C（P＞0.05）.After treatment,the proportion of exclusive breastfeeding of the women in the three groups had increased.The rate of exclusive breastfeeding and the excellent rate of exclusive breastfeeding of the women in group C were significantly higher than those of the women in group A and in group B（P＜0.01）.All the newborns after breast feeding by the women in the three groups during treatment had no abnormal situations,such as diarrhea:blood in the stool,or rash.There was no significant difference in the incidence of adverse reactions of the women between group B and group C（P＞0.05）.Conclusion:Shenghua decoction combined with misoprostol for treating the women with RPOC after natural delivery has better curative effect,which can promote the postpartum recovery of the women,can improve the treatment outcomes,and can promote breast-feeding,with safety,so it is worth of clinical application.

脐带是母胎间气体交换、营养物质供应和代谢产物排出的重要通道.脐带是胎儿循环中最薄弱部分,当脐带受压或出现病变时,可直接或间接引起胎儿血液循环障碍,导致胎儿缺氧、生长受限,甚至死亡[1].脐血管栓塞临床上极少见,但危害极大.因脐血管栓塞研究资料有限,目前国内外涉及的文献以个案报道居多,尚无大样本量的研究,故对于脐血管栓塞的治疗和监护策略尚未形成统一意见,多数病例在产前诊断后选择短期内剖宫产终止妊娠.本文将成都中医药大学附属医院产科收治的1例脐动脉栓塞伴羊水减少的期待治疗病例报道如下,并对近年来国内外有关脐血管栓塞的文献进行回顾,探讨脐血管栓塞的诊断和治疗方案.

目的:探讨置管后7d内启动腹膜透析(PD)的安全性及预后.方法:本研究回顾性分析了四川省人民医院PD中心2008-01-01～2016-12-31的腹膜置管后早期启动PD患者的并发症及导管存活情况,随访3年.根据置管后开始PD时间将患者分为三组,P1组(≤7d)、P2组(8～13d)、P3组(≥14d).所有患者均使用相同的PD起始剂量.研究的主要终点为导管技术失败,次要终点包括与PD相关的并发症及死亡.结果:本研究纳入437例患者,其中P1组163例、P2组189例、P3组85例.三组的1年和3年技术存活率分别为95.7％、92.6％、87.1％和94.5％、89.9％、85.9％(P=0.066).三组的 1 年和3年患者生存率分别为90.2％、94.2％、97.6％和81.0％、82.5％、85.9％(P=0.595).三组间围手术期并发症、感染并发症、导管通畅率、导管移位率无统计学差异.结论:置管术后7 d内启动PD患者与延迟开始透析者的导管技术存活率、患者生存率及PD相关并发症均无统计学差异,提示在置管后7 d内启动PD可作为常规治疗方式.

1 病例资料 患者陈某某,28岁,藏族,因"停经37+1周,阴道流液1+h"于2019年08月03日就诊于成都中医药大学附属医院产科.患者平素月经规律,5/28 d,停经45 d因"先兆流产"于我院妇科住院保胎治疗.

Objective To investigate the effect of modulating thrombomodulin (TM) expression on renal injury in a rat model of diabetic nephropathy (DN) and explore the possible mechanism. Methods We examined the expression of liver X receptor-α (LXR-α), TM, coagulation factor XⅢ-A (FXⅢ-A) and CD163 in 25 renal biopsy samples from patients with DN and in 6 normal renal tissue specimens using immunohistochemistry. Twenty-four 12-week-old male db/db mice with DN were randomly assigned into 4 equal groups and treated daily with intragastric administration of normal saline or LXR-α agonist T0901317, or with intravenous injection of an adenoviral vector carrying TM shRNA or the control adenoviral vector for 7 consecutive days; 6 wild-type C57BL6 mice with intragastric saline treatment served as the normal control group. Four weeks after the treatment, the expression of TM, LXR-α, FXⅢ-A and CD163 in the renal tissues of the mice were detected using Western blotting, the levels of tumor necrosis factor-α (TNF-α) and interleukine-6 (IL-6) were detected by ELISA, and the urinary microalbumin level was determined. Results The renal expression levels of TM and LXR-α were decreased (P < 0.05) and those of FXⅢ-A and CD163 were increased significantly (P < 0.05) in the kidney tissues of DN patients compared with normal kidney tissues. In db/db mouse model of DN, the expression levels of TM and LXR-α were positively correlated while those of FXⅢ-A and CD163 were negatively correlated with glomerular filtration rate (P < 0.05). Compared with the wild-type mice, the mouse model of DN showed significantly increased urinary microalbumin levels and serum levels of TNF-α and IL-6, lowered renal expressions of TM and LXR-α, and increased renal expression of FXⅢ-A and CD163; these changes were further exacerbated in the mice treated with Ad-TM shRNA (P < 0.05) but significantly improved in the mouse models treated with T0901317. Conclusion Upregulating TM expression can reduce urinary microalbumin level in db/db mouse model of DN by inhibiting the renal expression of FXⅢ-A and CD163 and downregulating blood levels of inflammatory mediators.

目的 了解艾尔巴韦/格拉瑞韦治疗丙型肝炎病毒(HCV)1b型感染透析患者的临床疗效及不良反应.方法 回顾性收集3例使用艾尔巴韦/格拉瑞韦抗病毒治疗的HCV 1b型感染透析患者的临床资料,查阅相关文献进行分析、总结.结果 2例血液透析及1例腹膜透析患者采用艾尔巴韦/格拉瑞韦抗病毒治疗,均获得持续病毒应答(SVR12),达到临床治愈标准.1例患者用药4周后出现明显血红蛋白下降,但在治疗12周时改善.1例患者新增疲乏表现,治疗结束后症状消失.治疗中3例患者均未因并发症而停药.结论 使用艾尔巴韦/格拉瑞韦治疗合并HCV 1 b型感染的血液透析及腹膜透析患者均有效,且无严重不良反应.

目的:分析导致腹透患者住院的主要原因及趋势.方法:收集10年我院随访的腹透患者的住院资料,对人口学资料、入院原因等进行分析.结果:(1)有401例患者在随访期发生1 172例次入院,平均住院日为19.34(11,23)d,年平均住院率为526住院次/1 000病人年.(2)腹透相关性疾病(41.7％)、呼吸道疾病(16.6％)、心脑疾病(16.0％)和消化道疾病(10.2％)是导致入院的前四位原因,占总住院例数的84.5％.(3)腹透相关并发症入院例数以＜44岁组最高,呼吸道疾病入院例数以60岁～74岁组最高,而心脑疾病、消化道疾病入院例数以≥75岁组最高(P ＜0.001).糖尿病患者因消化道疾病入院例数明显高于非糖尿病(P=0.028).(4)死亡患者的住院原因中腹透相关性疾病和心脑疾病分别占31.8％和22.7％,转血液透析患者主要入院原因为腹透相关性疾病和呼吸系统疾病(75.6％和9.8％).结论:腹透相关性疾病、呼吸系统疾病、心脑血管疾病及消化道疾病是腹透患者住院的主要原因,并易导致不良结局.

Objective To investigate the pathogenic bacteria,antibiotic resistance and prognosis of peritonitis in peritoneal dialysis(PD)patients.Methods 318 patients with peritonitis from January2009 to September 2016 were enrolled in this study.Pathogenic bacteria culture and drug sensitivity test of PD fluids were performance.The distribution of pathogenic bacteria and their resistance to antibiotics,and clinical outcomes of peritonitis were analyzed.Results(1)Distribution of pathogenic bacteria:185 cases were positively cultured in PD fluids(58.1%),resulting in a total of 194 strains of microorganisms,including 131 Gram-positive strains(67.5%),49 Gram-negative strains(25.2%)and 14 fungi strains(7.2%).Among Gram-positive strains,staphylococcus epidermidis and staphylococcus aureus were common pathogens,accounting for 25.9% and 10.6% respectively.Among Gram-negative strains,colibacillus was major pathogens,accounting for 40.8%.(2)The resistance to antibiotics of pathogenic bacteria:Drug sensitivity test showed Gram-positive strains had highest resistance against penicillin.Gram-negative strains had the highest resistance against ampicillin but the lowest resistance against piperacillin-tazobactam and cefoperazone-sulbactam.Fungi were sensitive to normal antifungal agents.(3)Prognosis of peritonitis:267 cases/times were cured(83.9%),51 cases dropped out of PD(16.0%),31 cases were subjected to the removal of catheter and transferred to hemodialysis(9.7%),13 cases were died(4.0%),and 7 cases lost to follow-up.(4)Analysis of pathogenic bacteria for relapsing,recurrence and repeat peritonitis:There were 2 cases of staphylococcus lugdunensis infection,1 case of staphylococcus epidermidis infection among 3 cases of relapsing peritonitis(0.94%).Moreover,1 case of recurrence peritonitis(0.31%)and 2 cases of repeat peritonitis(0.62%)were observed.Conclusions Gram-positive bacteria are major pathogenic bacteria in peritonitis patients in our center.Both Gram-positive and Gram-negative bacteria are high resistant to non-enzyme antibiotics.Sensitive antimicrobial therapy is the key to successfully treat peritonitis.

Objective To investigate the gastrointestinal symptoms in peritoneal dialysis( PD)patients and hemodialysis( HD) patients. Methods Eighty-nine PD patients( PD group) and 102 HD patients( HD group) in Department of Nephrology between July to August in 2015 were recruited in this study. The incidence and severity of gastrointestinal symptoms were assessed by the( gastrointestinal symptom rating scale,GSRS) and Gastroesophageal Reflux Disease Questionnaire( Gerd Q). Patients ’age,gender,duration of dialysis,history of diabetes,smoking,taking glucocorticoid and nonsteroidal anti-inflammatory drugs were recorded. Body mass index( BMI),blood hemoglobin( Hb),corrected calcium( c Ca),phosphorus,intact parathyroid hormone( i PTH),serum albumin( Alb),serum creatinine( SCr),blood urea nitrogen( BUN) and Kt/V were collected. Using T test and Chi-square test,the data were compared between two groups,and the main influencing factors of gastrointestinal symp-toms were screened out by stepwise multiple regression analysis. Results There was no statistically significant difference in age,gender,duration of dialysis,history of diabetes,smoking,taking glucocorticoid and nonsteroidal anti-inflammatory drugs between PD and HD groups. But the levels of serum albumin,BUN and achieving the goal of Kt/V were higher in HD group than in PD group. The prevalence of troublesome gastrointestinal symptoms( GSRS > 1) was 83. 1 % for PD,and 82. 4 % for HD. The mean GSRS scores in PD group were higher than in HD group( 4. 7 ± 4. 3 vs. 3. 8 ± 3. 3,P =0. 004). The occurrence rate of heart burn( P = 0. 029),reflux( P = 0. 001),nausea and vomiting( P = 0. 004) was higher in PD group than in HD group. Sixteen patients(18%) in PD group had determined gastroesophageal reflux by Gerd Q,which was significantly higher than in HD group( 8 patients,7 %). Stepwise multiple regression analysis revealed BMI was positively correlated to GSRS scores in dialysis patients( B = 0. 28,P = 0. 005),while hemoglobin was negatively correlated to GSRS( B =-0. 057,P = 0. 002). Conclusions Dialysis patients had a high prevalence of gastrointestinal symptoms. PD patients were particularly outstanding in gastroesophageal reflux symptoms. Gastrointestinal symptoms were related to BMI and hemoglobin.

目的 慢性肾脏病矿物质与骨异常(CKD-MBD)是CKD患者的常见并发症.关于CKD-MBD的现有数据重点关注血液透析(HD)患者.关于中国腹膜透析(PD)患者中CKD-MBD的研究极少,尤其缺乏大样本对比性研究.我们希望比较HD和PD的CKD-MBD相关参数.方法 收集本单位定期HD和PD患者的人口统计学资料.对于PD患者,采集空腹血标本及前1天全部尿液和透析液.对于HD患者,采集1周第1次透析前后血标本.测定标本的生化全套.计算CKD-MBD各相关指标达到KDIGO指南目标的患者百分数.比较两组间各变量差异.结果 入选499例患者,包括140例PD患者和359例HD患者.PD组血清磷(P)显著更低,血清钙(Ca)及全段甲状旁腺激素(iPTH)水平与HD组类似.PD组中P达标患者更多(HD组44.2%,PD组50.3%,P<0.01).相比之下,HD组中透析充分性达标患者更多(HD组88.5%,PD组58.7%,P<0.01).结论本研究结果表明PD患者血清P控制优于HD患者,而HD患者的透析充分性优于PD患者.

目的 慢性肾脏病矿物质与骨异常(CKD-MBD)是CKD患者的常见并发症.关于CKD-MBD的现有数据重点关注血液透析(HD)患者.关于中国腹膜透析(PD)患者中CKD-MBD的研究极少,尤其缺乏大样本对比性研究.我们希望明确与CKD-MBD相关参数有关的潜在影响因素.方法 收集本单位定期PD患者的人口统计学资料.采集空腹血标本及前一天全部尿液和透析液.测定血清标本的生化全套.测定24小时尿量以及腹透液与24小时尿液中肌酐(Cr)与尿素氮(BUN)浓度.根据公式计算周Kt/V、残余肾功能(RRF)和周肌酐清除率(Ccr).研究血清钙(Ca)、磷(P)和全段甲状旁腺激素(iPTH)的可能相关因素.结果 入选140例PD患者,其中男76例,女64例.具有更好残余肾功能的患者血P控制更佳.相关性分析表明血清钙与RRF、透析时间以及SCr和白蛋白(ALB)水平显著相关;血清P与RRF、Kt/V、周Ccr、BUN、透析时间以及SCr和ALB水平显著相关;血清iPTH与RRF、周Ccr、年龄、透析时间以及SCr和ALB水平显著相关.结论 本研究结果表明以RRF和24小时尿量作为残余肾功能评价指标时,具有更好残余肾功能的PD患者血清P、ALP和iPTH控制更好.因此保护残余肾功能对ESRD人群有重要意义.

Objective To investigate the occurrence of gastrointestinal symptoms and psychological abnormal state and their relationship in peritoneal dialysis ( PD) patients.Methods Gastrointestinal symptoms and psychological state of 89 PD patients treated in our hospital were assessed by using the gastrointestinal symptom rating scale ( GSRS) ,Hamilton Anxiety Scale ( HAMA) and Hamil-ton Depression Scale (HAMD).Patients'age,gender,dialysis duration,body weight index (BMI),blood pressure,blood hemoglobin, calcium,phosphorus,intact parathyroid hormone,albumin,creatinine,urea nitrogen and Kt/V were examined.Results The prevalence of troublesome gastrointestinal symptoms ( GSRS >1 ) was 83.1% in the study population.The investigation of psychological state showed that there were 2 patients with mild depress,23 patients with possible depress,13 patients with anxiety and 19 patients with pos-sible anxiety.The total rate of depress/anxiety was 50.6%.The GSRS scores in the depress/anxiety group were much higher than non-depress/anxiety group (P<0.05).Correlation analysis showed that GSRS scores were positively correlated with depress/anxiety and BMI,while negatively correlated to Kt/V (P<0.05).Conclusion The PD patients have high levels of gastrointestinal symptoms and high incidence of depression and anxiety.A remarkable correlation is observed between gastrointestinal symptoms and psychological state.

Objective To explore the effect of liver X receptor (LXR) agonist T0901317 on thrombomodulin (TM) expression in human glomerular endothelial cells (HUGECs) and its mechanism. Methods Western blot was used to detect the expressions of IκBα, p-IκBα, nuclear transcription factor-κB (NF-κβ) p65 and p-NF-κB p65 in HUGECs stimulated by 25 mmol high glucose and 2μmol T0901317. The interaction between LXR and the transcriptional coactivator p300 in HUGECs was detected using co-immunoprecipitation (Co-IP) assay. The concentrations of IL-1β and TNF-α in the supernatant of HUGECs transfected with or without AdTMshRNA were determined using commercially available ELISA kits. Results T0901317 (2 μmol) significantly reduced the phosphorylation of IκBα and NF-κB p65 in the HUGECs stimulated by high glucose ( <0.05). The activity of NF-κB was increased by LXR-α silencing despite the presence of T0901317. Co-IP revealed up-regulation of LXP and p300 in the HUGECs 24 h after stimulation by 2μmol T0901317. T0901317 inhibited the secretion of high glucose-induced inflammatory cytokines such as TNF-α and IL-1β in the HUGECs ( <0.05). The levels of TNF-α and IL-1β were increased by TM silencing with AdTMshRNA despite the presence of T0901317, but the differences were not significant ( >0.05). Conclusions LXR agonist increases TM expression and inhibits secretion of inflammatory mediators probably by competitively blocking the interaction between NF-κB and p300 through interaction with p300.

患者，男，66岁，因“维持透析10＋年，双下肢皮肤破溃半年”于2015年4月20日收住四川省人民医院城东病区肾脏科。患者10＋年前被诊断患尿毒症开始血液透析治疗，每周透析1次，7＋年前改为每周透析2次，长期未检测全段甲状旁腺素（iPTH）及血钙、血磷，亦未予钙剂及骨化三醇等治疗。半年前患者无明显原因及诱因出现双下肢多处皮肤破溃，双腿疼痛不能行走，多家医院考虑皮肤感染，反复给予消炎治疗，但症状不缓解。既往高血压病史10＋年，否认糖尿病、冠心病史。入院查体：体温37．3℃，血压113／68 mmHg，营养差，皮肤菲薄，双下肢股动脉及胫前动脉搏动良好，双下肢小腿胫前多处皮肤溃疡，最大直径7 cm，表面少许乳白色黏液渗出（图1）。辅助检查：CT 见双侧小脑半球、基底节、四脑室后壁、大脑镰区域见较多斑点状钙斑影，颈内动脉颅内段、双侧椎动脉远端管壁及头皮内血管见有较多钙斑影，心影增大，冠脉区域见有钙斑影，主动脉壁、肺门及胸廓软组织影内见较多大小不等的斑点状钙斑影。心脏彩超见左室肥大，左房肥大。血管彩超见双侧小腿肌间静脉扩张，右侧股总静脉、右侧腘静脉血流淤积缓，双侧股总动脉、腘动脉、胫后动脉、胫前动脉、足背动脉粥样硬化伴不均匀回声斑块形成伴中－重度狭窄。血清梅毒抗体阳性，滴度原倍。 iPTH 3437．8 pg ／ml；血红蛋白115 g／L；尿素氮26．35 mmol ／L，肌酐1118μmol ／L，钙2．06 mmol ／L，磷2．9 mmol ／L，碱性磷酸酯酶（ALP）379 U／L，核抗原抗体－Ro52（Anti－Ro52）（＋），抗 CENP B 抗体（Anti－CEN）（＋）。抗中性粒细胞胞浆抗体（ AN－CA），抗核抗体（ANA）、肿瘤标志物、补体、类风湿因子、抗 O、免疫球蛋白无异常。病变皮肤活检提示表皮及纤维脂肪组织可见较多坏死及钙化灶（图2）。诊断：继发性甲状旁腺功能亢进，钙化防御综合征，建议行甲状旁腺切除术。

腹膜透析（peritoneal dialysis，PD）是治疗终末期肾病的重要措施之一。随着 PD 患者存活时间延长，慢性肾脏病－矿物质和骨异常（chronic kidney disease mineral and bone disorder ，CKD－MBD）已经成为影响其生命和生活质量的重要并发症，导致患者心血管及全因死亡率增加。高磷血症是 CKD－MBD 发生的始动环节。与血液透析患者相比，PD 患者的血钙、磷、甲状旁腺素水平相对稳定，更易发生低转运性骨病。这些差异由多种因素导致，其中 PD 患者的残余肾功能、腹膜转运特点及PD 液等因素都会影响 PD 患者的钙磷代谢，从而影响其 CKD－MBD。

钾通道是一个种类繁多、结构复杂、分布广泛的多样化蛋白家族,在多种血管内皮细胞和平滑肌细胞的生理活动中发挥着重要作用.目前随着"离子通道病"研究的日益深入,胎盘血管钾通道与某些妊娠并发症的关系也逐渐引起了人们的关注.本文通过综述相关研究进展,为钾通道对胎盘血管张力的调控作用提供可能依据,从而更好地阐明胎盘血管相关异常妊娠的病理生理机制.

目的探讨微量蛋白尿(MA)与缺血性脑卒中(CIS)之间的关系。方法 2009年2月至2012年2月通过检测缺血性脑卒中患者的微量蛋白尿,并与有血管危险因素的非卒中对照组患者进行临床资料、空腹血糖、TC、TG、HDL-C、LDL-C、MA等临床指标的比较研究,以探讨微量蛋白尿与缺血性脑卒中的联系。结果两组患者的年龄、性别及并发症比较无明显差异(χ2或t=1.01、0.35、1.22、0.68、3.54,P>0.05);两组的血脂异常和血液生化检查结果比较亦无明显差异(χ2或t=0.34、1.39、0.58、0.46、0.29,P>0.05)。但是两组患者的微量蛋白尿检出率比较有明显差异,且差异具有统计学意义(χ2=8.06,P<0.05)。经多因素Logistic回归分析显示微量蛋白尿是缺血性脑卒中的危险因素。不同神经功能缺损程度患者的MA阳性率比较有明显差异(F=4.12,P<0.05)。结论微量蛋白尿是缺血性脑卒中的危险因素,而随访复查微量蛋白尿对于判断神经功能缺损及预后起着一定的作用。