血尿酸与急性脑梗死中国缺血性卒中亚型分型及预后的相关性  

The correlation between serum uric acid level and CISS classification along with its prognosis in acute cerebral infarction

作　　者：甘秀红 王君梅[1] 张东圆[1] 田沈[1] 

机构地区：[1]中国医科大学附属第四医院神经内科,沈阳100032

出　　处：《山西医药杂志》2016年第1期3-5,共3页Shanxi Medical Journal

基　　金：辽宁省科学技术计划项目(2013225049)

摘　　要：目的研究血尿酸与急性脑梗死中国缺血性卒中亚型(CISS)分型各亚型的关系及对近期预后的影响。方法回顾性分析522例住院急性脑梗死患者的病史及相关检查结果,按CISS分型标准对所有患者进行分型,并对各亚型的血尿酸水平分布资料进行多分类资料的关联分析,明确血尿酸与各亚型的关系。同时根据血尿酸水平将所有患者分为高尿酸组和正常尿酸组,每个患者入院及发病2周进行美国国立卫生研究院卒中量表(NIHSS)评分,将评分的差值作为结局变量,分为预后良好(NIHSS差值≥4分)组及预后不良(NIHSS差值<4分)组,观察血尿酸对预后的影响。结果 1522例患者CISS分型中,大动脉粥样硬化为主,穿支动脉疾病次之。2各分型中,大动脉粥样硬化型的尿酸与其他3组差异均有统计学意义:大动脉粥样硬化型与心源性卒中型(F=45.69,P=0.008);与穿支动脉疾病型(F=90.80,P=0.001);与其他型(F=65.69,P=0.013)。3高血尿酸组较正常尿酸组入院时、发病2周的NIHSS评分差异有统计学意义(χ2=59.022,P=0.001)。结论急性脑梗死CISS分型中以大动脉粥样硬化、穿支动脉疾病所占比例较高;血尿酸水平与各亚型存在相关性,高尿酸与近期不良预后有明显相关。Objective To explore the correlation between serum uric acid （UA） level and CISS classification along with its short-term prognosis in acute cerebral infarction. Methods We analyzed the medical history and the results of relevant auxiliary examination in 522 patients hospitalized with acute cerebral infarction retrospectively. All the patients were classified into different subtypes according to the CISS classification. The distribution data of UA level in the patients with different subtypes was analyzed in order to define the correlation between UA and various subtypes. According to the different UA levels, all the patients were distributed into high UA level group and normal UA level group. And NIH Stroke Scale （NIHSS） score was conducted for every patient on admission and in 2 weeks after onset. The NIHSS score difference was defined as outcome variable, then the patients were categorized as favorable （NIHSS difference 94 points） or poor （NIHSS difference 〈4）. Basing on that, we ob- served the effect of UA on the short-term prognosis. Results （1）Among the 522 patients classified by CISS classification, the large artery atherosclerosis （LAA） was most common, and the perforating artery disease （PAD） ranked second; （2）Among the different subtypes, difference of UA levels was statistically significant. The difference between the large artery atherosclerosis （LAA） subtype and the cardiac stroke （CS） subtype had a distribution of F=45.69, P= 0. 008, while that between the large artery atherosclerosis （LAA） and perforator artery disease （PAD） subtype had a distribution of F= 90.80, P= 0. 001 as well as that between the large artery atherosclerosis （LAA） and the other etiologies （OE） subtype with a distribution of F=65.69, P=0. 013; （3）There were statistical significance between high UA level group and normal UA level group in the difference of NIHSS scores between admission and 2 weeks after onset. Conclusion Among the subtypes of acute cerebral infarctio

关 键 词：脑梗塞 尿酸 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]