血尿酸水平与缺血性脑卒中亚型之间的关系研究  

A study on correlation between serum uric acid levels and ischemic stroke subtypes

作　　者：金皎蕾 张丹红[1] 肖玲琴 齐玉祥[1] 

机构地区：[1]台州市中心医院神经科,浙江台州318000

出　　处：《中国中西医结合急救杂志》2013年第2期96-98,共3页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

摘　　要：目的探讨血尿酸水平与缺血性脑卒中不同亚型之间的关系。方法205例缺血性脑卒中患者，按急性卒中治疗低分子肝素试验（TOAST）标准分为大动脉粥样硬化型（LAA）、心源性栓塞（CE）、小动脉闭塞性卒中或腔隙性卒中（SAO）、其他有明确原因所致的缺血性卒中（SOE）、不明原因的缺血性卒中（SUE）。对照组80例为同期健康体检者。采清晨空腹静脉血，测定尿酸水平。结果①病例组伴高血压、糖尿病、吸烟者[例（％）]均明显高于对照组[高血压：133（64．9％）比14（17．5％），糖尿病：37（18．0％）比2（2．5％），吸烟：82（40．0％）比18（22．5％），均P〈0．01]。②缺血性脑卒中患者的尿酸（μmol／L）水平明显高于对照组（307．38±81．60比277．06±75．17，P〈0．01）。⑧LAA77例（37．6％），CE12例（5．8％），SAO43例（21．0％），SOE4例（2．0％），SUE69例（33．6％）；LAA组和SUE组尿酸（μmol／L）水平均明显高于对照组（315．50±83．85、310．54±77．78比277．06±75．17，均P〈0．05），SAO组（296．16±89．82）与对照组比较差异无统计学意义（P〉0．05）。结论尿酸可能是缺血性脑卒中的一个危险因素；血尿酸增加卒中风险的机制可能主要与其促动脉粥样硬化作用有关；降低尿酸水平是否对缺血性脑卒中有益尚需进一步研究。Objective To investigate the relationship between the levels of serum uric acid and different subtypes of ischemic stroke. Methods According to the standard of Trial of Org 10172 in acute stroke treatment （TOAST）, 205 patients with ischemic stroke were divided into following groups ： large artery atherosclerosis （LAA）, cardioembolism （CE）, small artery occlusion （SAO）, stroke of other determined etiology （SOE） and stroke of other undetermined etiology （SUE）. Eighty healthy people were enrolled as the control group. Fasting venous blood was collected in the morning and the serum uric acid levels were tested after hospitalization. Results ① The incidences of hypertension, diabetes and smoking in the patient groups were significantly higher than those of the control group （ hypertension ： 133 （64.9%） vs. 14 （17.5%）, diabetes ：37 （18.0%） vs. 2 （2.5%）, smoking ： 82 （40.0%） vs. 18 （22.5%）, all P〈0.011. ② The level of uric acid （μmol/L） in ischemic stroke patients was significantly higher than that of control group （307.38±81.60 vs. 277.06±75.17, P〈0.01） . ③ There were LAA 77 cases （37.6%）, CE 12 cases （5.8%）, SAO 43 cases （21.0%）, SOE 4 cases （2.0%） and SUE 69 cases （33.6%）. Compared with control group, the levels of uric acid （μmol/L） in LAA group and SUE group were significantly higher （315.50 ± 83.85,310.54± 77.78 vs. 277.06 ± 75.17, both P〈 0.05 ） . There was no statistically significant difference between SAO group （296.16 ± 89.82） and control group （P〉0.05）. Conclusions Uric acid may be a risk factor for ischemic stroke ; the mechanism of its increment of blood level enhancing the risk of occurrence of ischemic stroke is possibly related mainly to its promotion of atherosclerosis. Whether lowering of uric acid level can decrease the incidence of ischemic stroke needs further study.

关 键 词：尿酸 脑卒中 急性卒中治疗低分子肝素试验分型 

分 类 号：R743.3[医药卫生—神经病学与精神病学]