血尿酸水平与脑梗死急性期脑血管狭窄的关系  

Relationship between serum uric acid level and cerebrovascular stenosis in acute ischemic stroke patients

作　　者：陈慧丰[1] 杨丹丹[1] 姚源蓉[2] CHEN Hui-feng YANG Dan-dan YAO Yuan-rong(Department of Neurology ,General Hospital of Tianjin Medical University, Tianjin 300052, Chin)

机构地区：[1]天津医科大学总医院神经内科,300052 [2]贵州医科大学附属医院神经内科

出　　处：《中华老年心脑血管病杂志》2017年第5期503-506,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：国家自然科学基金(81271409)

摘　　要：目的探讨血尿酸水平与脑梗死复发和脑血管狭窄的关系。方法选择2014年4月~2016年4月在天津医科大学总医院神经内科住院的急性脑梗死和陈旧性脑梗死患者共513例,急性脑梗死包括初发脑梗死236例(初发脑梗死组)和复发脑梗死136例(复发脑梗死组),陈旧性脑梗死患者141例(陈旧性脑梗死组)。入院当天采集静脉血进行生化检查,所有患者又按照血尿酸水平四分位数分为第一分位(尿酸≤255μmol/L,128例),第二分位(尿酸256~312μmol/L,129例),第三分位(尿酸313~371μmol/L,129例),第四分位(尿酸>371μmol/L,127例)。住院期间做CT血管成像或磁共振血管造影术评价脑血管狭窄程度。结果初发脑梗死组、复发脑梗死组及陈旧性脑梗死组重度血管狭窄程度、高血压、糖尿病及高脂血症比例比较,差异有统计学意义(27.5%vs 33.8%vs12.8%、24.2%vs 28.7%vs 46.8%、61.9%vs 49.3%vs 40.4%、71.6%vs 61.8%vs 46.8%,P=0.000)。logistic回归分析显示,第一分位血尿酸水平为脑血管狭窄的独立危险因素(OR=2.787,95%CI:2.209~3.365,P=0.001),而且随着血尿酸分层升高,脑血管狭窄程度的相对危险度逐渐减弱。结论血尿酸水平与脑梗死复发可能无直接相关性。脑梗死急性期低血尿酸水平可能是脑血管狭窄的独立危险因素。Objective To study the relationship between serum uric acid（UA）level and cerebrovascular stenosis in acute ischemic stroke（AIS）patients.Methods Five hundred and thirteen patients with AIS or old IS admitted to our hospital from April 2014 to April 2016 were divided into primary IS group（n=236）,recurrent IS group（n=136）,and old IS group（n=141）.Venous blood samples were taken on admission for biochemical testing.The patients were further divided into serum UA≤255μmol/L group（n=128）,serum UA=256-312μmol/L group（n=129）,serum UA=313-371μmol/L group（n=129）,and serum UA371μmol/L group（n=127）.Their cerebrovascular stenosis was assessed by CT angiography or magnetic resonance angiography after admission.Results The severity of cerebrovascular stenosis,hypertension,diabetes and hyperlipidemia was significantly different in primary IS group,recurrent IS group and old IS group（27.5%vs 33.8%vs 12.8%、24.2%vs 28.7%vs 46.8%、61.9%vs 49.3%vs 40.4%、71.6%vs61.8%vs 46.8%,P=0.000）.Logistic regression analysis showed that serum UA≤ 255μmol/L was an independent risk factor for cerebrovascular stenosis（OR=2.787,95%CI：2.209-3.365,P=0.001）.The risk of cerebrovascular stenosis decreased gradually with the elevated serum UA level.Conclusion Serum UA level is not directly related with recurrent IS.Low serum UA level is a risk factor for cerebrovascular stenosis in AIS.

关 键 词：尿酸 脑梗死 脑血管障碍 磁共振血管造影术 高血压 糖尿病 高脂血症 

分 类 号：R743.33[医药卫生—神经病学与精神病学]