肾功能受损易发生脑部小血管病变

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Kidney Function Is Related to Cerebral Small Vessel Disease
肾功能受损易发生脑部小血管病变
Background and Purpose— Poor kidney function, as measured by glomerular filtration rate (GFR), is closely associated with presence of glomerular small vessel disease. Given the hemodynamic similarities between the vascular beds of the kidney and the brain, we hypothesized an association between kidney function and markers of cerebral small vessel disease on MRI. We investigated this association in a population-based study of elderly persons.
背景及目的:据肾小球滤过率评估出的肾功能不全和肾小球小血管疾病密切相关，而根据肾脏和脑部血管床血液动力学具有相似性这一要点，我们假设肾功能和脑部小血管疾病有关，而这会在核磁影像上有所表现。就此，我们
对老年人进行了人口学研究。
Methods— We measured GFR using the Cockcroft-Gault equation in 484 participants (60 to 90 years of age) from the Rotterdam Scan Study. Using automated MRI-analysis we measured global as well as lobar and deep volumes of gray matter and white matter, and volume of WML. Lacunar infarcts were rated visually. Volumes of deep white matter and WML and presence of lacunar infarcts reflected cerebral small vessel disease. We used linear and logistic regression models to investigate the association between GFR and brain imaging parameters. Analyses were adjusted for age, sex, and additionally for cardiovascular risk factors.
方法：调查对象：鹿特丹调查中的484位受试者，年龄分布为60到90岁不等。应用Cockcroft-Gault公式计算出受试者的肾小球滤过率，利用全自动核磁分析整个大脑及各脑室的白质灰质的深度，以及脑室容积。人工视觉判断
腔隙性梗塞的程度，深灰质的容积、脑室容积及腔隙性梗塞的存在与否反应脑部小血管病变的程度。应用直线方程和logistic回归研究肾小球滤过率和脑部影像参数之间的关系。此分析还据年龄、性别、心血管风险因子进行校正。
Results— Persons with lower GFR had less deep white matter volume (difference in standardized volume per SD decrease in GFR: –0.15 [95% CI –0.26 to –0.04]), more WML (difference per SD decrease in GFR: 0.14 [95% CI 0.03 to 0.25]), and more often lacunar infarcts, although the latter was not significant. GFR was not associated with gray matter volume or lobar white matter volume. Additional adjustment for cardiovascular risk factors yielded similar results.
结果：肾小球滤过率越低并且脑白质越少、脑室容积越大的患者更容易发生腔隙性梗塞，尽管这种梗塞并不是很严重。肾小球滤过率与灰质容积及脑页白质容积没有直接联系。
Conclusions— Impaired kidney function is associated with markers of cerebral small vessel disease as assessed on MRI.
结论:据对核磁影响的评估得出结论,肾功能受损与脑部小血管病变有关。同步进行的心血管风险因子校正也得出相似的结论。
Stroke. 2008;39:55-61
《脑卒中》.2008;39:55-61
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从中国期刊网可以确认，低能量激光血管内照射治疗方法可以治疗脑血管疾病和肾相关疾病。本帖进一步支持这种疗效。