血清尿酸水平与急性脑卒中短期临床结局的关系  

Association between serum uric acid and short-term clinical outcome among patients withacute stroke

作　　者：张晓龙[1] 张金涛 彭颖[3] 许锬[1] 张永红[1] 

机构地区：[1]苏州大学医学部公共卫生学院流行病学教研室,215123 [2]济南军区第八十八医院 [3]浙江省疾病预防控制中心

出　　处：《中华流行病学杂志》2012年第5期529-533,共5页Chinese Journal of Epidemiology

摘　　要：目的探讨血清尿酸水平与急性脑卒中短期临床结局的关系。方法以3231例住院急性脑卒中患者为研究对象，收集人口统计学、生活方式、疾病史、入院尿酸及出院结局等临床特征资料。将出院时神经功能评分≥10或住院期间死亡定义为不良结局。结果入院时尿酸水平升高与急性缺血性脑卒中患者短期不良结局的危险性下降有关。经多因素调整后，尿酸水平每升高1个单位，发生不良结局的OR=O．856（95％CI：0．795-0．898）。按尿酸水平的5分位分析，经多因素调整后，与尿酸〈197μmol／L者相比，尿酸水平在197-241、242-285、286-346和≥347μmol／L的缺血性脑卒中患者发生不良结局的OR值（95％CI）分别为0．552（0．354-0．861）、0．417（0．263-0．661）、0．390（0．241。0．630）和0．352（0．213-0．581），呈现随尿酸水平升高，不良结局危险胜而下降的趋势。出血性脑卒中患者尿酸水平每升高1个单位，发生不良结局的OR值无统计学意义。按尿酸水平的5分位进行分析，经多因素调整后，与尿酸〈150μmol／L者相比，尿酸水平在150-185、186-230、231-297和／〉298μmol／L的出血性脑卒中患者发生不良结局的OR值也无统计学意义。结论血清尿酸水平升高是急性缺血性脑卒中患者短期预后良好的独立预测因子。Objective To investigate the association between serum uric acid （SUA） and early clinical outcome among patients with acute stroke. Methods A total of 3231 acute stroke patients were included in the present study. Data on demographic characteristics, life style risk factors, history of disease, admission SUA and clinical outcome at discharge were collected for all participants. Poor clinical outcome was defined as neurologic deficiency （NIHSS≥10） at discharge or death during hospitalization. Results Increased SUA level was associated with decreased risk of poor outcome among ischemic stroke patients. After adjustment for multivariate, the odds ratio （95% confidence interval） of poor outcome for every increased unit was 0.856 （0.795-0.898） among ischemic stroke patients. Logistic analysis was conducted according to quintile of SUA level, after adjustment for multi-variates, the odds ratio （95% confidence interval） of poor clinical outcome appeared to be associated with SUA of 197-241 μmol/L, 242-285 μmol/L, 286-346 gmol/L and ≥ 347 μmol/L, but were 0.552 （0.354-0.861） , 0.417 （0.263-0.661） , 0.390 （0.241-0.630） and 0.352 （0.213-0.581） , respectively in those acute ischemic stroke patients, when compared to those with SUA〈 197μmol/L. Among acute hemorrhagic stroke patients, after adjustment for multivariate, the odds ratio （95% confidence interval） of poor outcome for every increased unit was not significant among hemorrhagic stroke patients. According to the quintile of SUA level, when compared to those with SUA〈 150μmol/L, the odds ratio（95% confidence interval） of poor clinical outcomes associated with SUA of 150-185 μmol/L, 186-230 μmol/L, 231-297 μmol/L and ≥298 μmol/L, were also not significant among those hemorrhagic stroke patients. Conclusion Elevated SUA seemed to be an independent predictor for short-term good clinical outcome among acute ischemic stroke patients.

关 键 词：脑梗死 脑出血 尿酸 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]