老年脑梗死患者血尿酸水平与颈动脉硬化及颅内动脉血流动力学变化的相关性研究  

作　　者：李太勇[1] 姜辉[1] 方烨[1] 李娟[1] 

机构地区：[1]广州军区武汉总医院干部病房一科,430070

出　　处：《浙江临床医学》2016年第6期1046-1048,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨老年脑梗死患者血尿酸（UA）水平与颈动脉硬化及颅内动脉血流动力学变化之间的关系。方法住院治疗〉60岁脑梗死患者186例，记录临床资料，测定血尿酸，根据尿酸水平，分为高尿酸血症组（104例）及尿酸正常组（82例），比较两组的基线资料、临床特征及颈动脉彩色多普勒（CDFI）及经颅多普勒（TCD）检查结果，并分析颈动脉硬化的影响因素。另选40例健康体检老年人作为对照组。结果高尿酸血症组患者颈动脉内中膜厚度及颈动脉斑块发生率明显高于尿酸正常组和对照组（P〈0．05），尿酸增高组颈动脉内中膜厚度较对照组明显增加（P〈0．05），脑梗死尿酸增高组患者颈总动脉和颈内动脉收缩期峰值血流速度（PSV）、舒张末期血流速度（EDV）、血流最大剪切率（SR）减少，低于对照组（P均〈0.01），血管阻力指数（RI）较对照组明显增大（P〈0．05）。结论老年脑梗死患者存在颈动脉结构及血流动力学改变，且颈动脉硬化程度与高尿酸有关。提示高尿酸血症是动脉硬化的独立危险因素。彩色多普勒及经颅多普勒联合检测对预防脑梗死的发生、判断预后、指导早期治疗具有重要作用。Objective To investigate the relationship between serum uaic acid （ UA ） level and carotid artery arteriosclerosis and blood hemodynamics changes of intraeranial arteries in elder patients with cerebral infarction. Methods A total of 186 cases of cerebral infarction patients aged 60 years or older who were admitted to our hospital, were selected as study subjects, clinical information was recorded, levels of serum UA were measured.According to the Results of UA, patients were divided into two groups as hyperuricemia group （ 104 cases ） and normal uric acid group （ 82 cases ） .40 healthy people were selected as control group.The basal data, clinical feature and color doppler flow imaging （ CDFI ） and transcranialdoppler （ TCD ） results were compared between the two groups.the influencing factors for carotid artery arteriosclerosis were analyzed. Results The carotid artery intima-media thickness （ IMT ） , the incidencerate of plaque in hyperuricemia group was higher than without hyperuricemia group and control group （ P〈0.05 ） .IMT in the patient with hyperuricemia group was higher than it in the normal control group （ P〈0.05 ） .the PSV, EDV, SR were significantly lower than that in control group （ P〈0.01 ） .RI was higher than in control group （ P〈0.05 ） . Conclusion Hyperuricemia is a major risk factor for carotid artery IMT hyperplasia and the development of plaquea theromatous of cerebral infarction. And it influence on intracranial artery blood flow.It plays an important role in preventing the occurrence of cerebral infarction, and predicting prognosis and guiding the early treatment by use of CDFI and TCD.

关 键 词：脑梗死 高尿酸血症 颈动脉 彩色多普勒经 颅多普勒 

分 类 号：R774.6[医药卫生—眼科]