入院时尿酸水平可能对急性脑梗死患者出院转归存在U型曲线影响  

Uric acid may have a U-curve effect on the outcome of discharged patients with acute cerebral infarction

作　　者：周硕[1] 孙秀艳[1] 佟伟军[2] Zhou Shuo;Sun Xiuyan;Tong Weijun(Department of Neurology,the Fuxin Central Hospital,Liaoning 123000,China)

机构地区：[1]阜新市中心医院神经内科,辽宁123000 [2]苏州大学医学部公共卫生学院流行病与卫生统计学教研室

出　　处：《脑与神经疾病杂志》2018年第9期529-534,共6页Journal of Brain and Nervous Diseases

基　　金：国家自然科学基金项目(81172760)

摘　　要：目的探讨入院时尿酸(UA)水平可能对急性脑梗死(ACI)患者出院转归存在U型曲线影响。方法选择2011年6月1日至2014年5月31日阜新市中心医院神经内科3151例住院的ACI患者,收集入院时UA水平,3≤MRS≤6定义为预后不良组,不同预后组间基线资料的比较采用t检验、χ~2检验以及秩和检验。将入院时UA水平按照5分位数法分为5组,第1组为≦212μmol·L^(-1),第2组为213~255μmol·L^(-1),第3组为256~297μmol·L^(-1),第4组为298~351μmol·L^(-1),第5组为≧352μmol·L^(-1)组。采用非条件Logistic回归分析入院时UA水平与ACI患者出院时预后的关系。结果预后不良组的UA水平低于预后良好组且分布不同,差异有统计学意义(P<0.05)。按照5分位数法将入院时UA水平分组后,1~5组的预后不良发生率分别为35.22%、30.95%、28.55%、23.85%、30.03%。5组之间的预后不良发生率差异有统计学意义(P=0.0002)。经多因素调整后,以UA水平298~351μmol·L^(-1)组为参比组,第1、2、3、5组相对于参比组的OR值(95%CI)分别为1.658(1.185~2.319)、1.430(1.024~1.999)、1.638(1.181~2.272)、1.474(1.050~2.069),均P<0.05。结论 ACI患者入院时UA水平和出院时预后不良发生率之间呈现近U型关系,UA水平较低或者较高可能都不利于ACI患者的预后。Objective To investgate the relationship that serum uric acid(UA)may have a U-curve effect on the outcome of discharged patients with acute cerebral infarction(ACI).Method we included 3151 patients with ACI from June 1 2011 to May 31 2014 in Fuxin central hospital.3≤MRS≤6 was defined as poor outcome.t-test,χ2 test and Wilcoxon signed rank test were used to analyse the difference of variables between good outcome group and poor outcome group.According to the quintile range of serum UA,patients were divided into 5 groups(≤212μmol·L-1,213-255μmol·L-1,256-297μmol·L-1,298-351μmol·L-1,≧ 352μmol·L-1).Logistic regression analysis was used.Results UA on admission was lower in patients with poor outcome than in those with good outcome(P<0.05).After dividing the patients into 5 groups,the proportion of poor outcome in each group were 35.22%,30.95%,28.55%,23.85%,30.03%respectively(P<0.05).After adjustment of multivariate,compared with the UA 298-351umol·L-1 group,the OR(95%CI)of first,second,third,fifth group were 1.658(1.185-2.319),1.430(1.024-1.999),1.638(1.181-2.272),1.474(1.050-2.069),respectively(P<0.05).Conclusion UA may have a U-shaped effect on the outcome of discharge patients with ACI.Lower or higher UA may have a bad effect on the outcome of ACI.

关 键 词：急性脑梗死 尿酸 预后 

分 类 号：R743.32[医药卫生—神经病学与精神病学]