Influence of estimated glomerular filtration rate in motor function rehabilitation and short-term prognoses in patients with acute middle cerebral artery infarction
10.3760/cma.j.issn.1671-8925.2019.11.006
- VernacularTitle:肾小球滤过率对急性大脑中动脉梗死患者肢体运动功能康复及短期预后的影响
- Author:
Yi ZHANG
1
;
Min ZHANG
;
Wenwei YUN
;
Yin CAO
;
Yuan CHEN
;
Zhixiang ZHANG
;
Yu TAO
;
Jingjing WANG
;
XianJu ZHOU
Author Information
1. 南京医科大学附属常州第二人民医院神经内科 213003
- Keywords:
Cerebral infarction;
Middle cerebral artery;
Estimated glomerular filtration rate;
Motor function;
Rehabilitation;
Short-term prognosis
- From:
Chinese Journal of Neuromedicine
2019;18(11):1109-1115
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the influence of estimated glomerular filtration rate (eGFR) in rehabilitation of motor function and short-term prognoses in patients with acute middle cerebral artery (MCA) infarction. MethodsSeventy-four patients with acute MCA infarction, admitted to Department of Neurology from March 2016 to September 2018, and then, accepted rehabilitation training for 4 weeks in Department of Rehabilitation medicine, were recruited. Modification of Diet in Renal Disease was used to evaluate the eGFR instead of renal function; according to the results, these patients were divided into normal renal function group and mild-moderate renal dysfunction group. National Institute of Health Stroke Scale (NIHSS) was used to assess the neurologic function. Fazekas scale was used to assess degrees of leukoaraiosis. Fugl-Meyer Motor Function Assessment (FMA) was used to assess motor functions before rehabilitation treatment and 90 d after onset. Modified Barthel Index (MBI) was used to assess activity of daily living 90 d after onset. According to MBI scores, the patients were divided into good prognosis group (MBI scores>60) and poor prognosis group (MBI scores≤60); multivariate Logistic regression analysis was used to confirm the risk factors affecting prognoses 90 d after onset.ResultsAmong 74 enrolled patients, 40 were classified as normal renal function group and 34 as mild-moderate renal dysfunction group; patients in the mild-moderate renal dysfunction group had significantly higher level of blood urea nitrogen, proportion of silent lacunar cerebral infarction and Fazekas scale scores, and had statistically lower FMA scores and MBI 90 d after onset than normal renal function group (P<0.05). Among the 74 patients, good prognosis was found in 32 patients and poor prognosis in 42 patients; multivariate Logistic regression analysis found that age, eGFR (OR=0.944,P= 0.011, 95％CI: 0.903-0.987), baseline NIHSS scores, and Fazekas scale scores were risk factors affecting prognoses 90 d after onset.ConclusionIn acute MCA infarction patients, eGFR can influence the rehabilitation of motor function and short-term prognoses.
