高尿酸血症对急性缺血性脑卒中合并2型糖尿病患者出院结局影响研究  

The impact of Hyperuricemia on the clinical outcome of type 2 diabetic patients with acute ischemic stroke

作　　者：王萍 汤颖[2] 李欣彦 王玉娜 赵景波 WANG Ping;TANG Ying;LI Xin-yan;WANG Yu-na;ZHAO Jing-bo(School of Public Health,Harbin Medical University,Harbin,Heilongjiang 150081 ,China)

机构地区：[1]哈尔滨医科大学公共卫生学院流行病学教研室,黑龙江哈尔滨150081 [2]哈尔滨医科大学附属第一医院神经内科卒中病房

出　　处：《中国预防医学杂志》2018年第12期904-907,共4页Chinese Preventive Medicine

基　　金：黑龙江省自然科学基金项目(D201235)

摘　　要：目的研究降糖药物不同依从性情况下高尿酸血症对急性缺血性脑卒中(acute ischemic stroke,AIS)合并2型糖尿病患者出院结局的影响。方法选取2016年4月至2017年12月哈尔滨医科大学附属第一医院神经内科卒中病房进行住院治疗的AIS伴2型糖尿病患者,收集一般人口学资料、既往病史、现病史、实验室检查和入院病情严重程度等,进行前瞻性队列研究。结果共收集病例340例,降糖药物依从性好的患者196例,降糖药物依从性差的患者144例。两组患者间高血压病史(χ~2=4.136,P=0.042);出院mRS评分(χ~2=6.721,P=0.010);总胆固醇(t=4.71,P<0.01);高密度脂蛋白胆固醇(t=4.55,P<0.01)及低密度脂蛋白胆固醇(t=4.38,P<0.01)差异有统计学意义。高尿酸血症是降糖药物依从性差组AIS伴2型糖尿病患者出院预后不良的独立预测因素(OR=5.352,95%CI:1.493～19.184),但与降糖药物依从性好组AIS伴2型糖尿病患者出院预后无关(OR=1.164,95%CI:0.427～3.172)。结论对于降糖药依从性差的2型糖尿病患者,高尿酸血症是其AIS出院预后不良的独立预测因素。Objective To observe the impact of hyperuricemia on the clinical outcome of type 2 diabetic acute ischemic stroke(AIS)patients with different hypoglycemic drug compliance. Methods A prospective cohort study was conducted among type 2 diabetic AIS patients hospitalized in The First Affiliated Hospital of Harbin Medical University from April 2016 to December 2017. Results A total of 340 patients were included in the study(196 patients with good hypoglycemic compliance and 144 patients with poor hypoglycemic drug compliance).There were statistical significance in history of hypertension(χ^2=4.136,P=0.042),out-hospital mRS scores(χ^2=6.721,P=0.010),serum levels of total cholosteral(t=4.71,P<0.01),high-density lipoprotein(t=4.55,P<0.01)and low-density lipoprotein(t=4.38,P<0.01)between patients in two groups.Hyperuricemia was an independent predictive factor of clinical outcomes of patients with poor hypoglycemic drug compliance(OR=5.352,95%CI:1.493-19.184),not for patients with good hypoglycemic drug compliance(OR=1.164,95%CI:0.427-3.172). Conclusions Hyperuricemia is found to be an independent predictive factor of in-hospital outcomes of type 2 diabetic AIS patients with poor hypoglycemic drug compliance.

关 键 词：急性缺血性脑卒中 高尿酸血症 糖尿病 药物依从性 前瞻性队列研究 

分 类 号：R743[医药卫生—神经病学与精神病学]