2型糖尿病患者血清尿酸水平与缺血性脑卒中的相关性研究  

Association between serum uric acid levels and ischemic stroke in patients with type 2 diabetes mellitus

作　　者：孔令斯 陶敏 施映枫 蒋晓露 金德伟 刘娜[1] KONG Ling-si;TAO Min;SHI Ying-feng;JIANG Xiao-lu;JIN De-wei;LIU Na(Dept.of Nephrology,East Hospital,Tongji University,Shanghai 200120,China)

机构地区：[1]同济大学附属东方医院肾内科,上海200120

出　　处：《同济大学学报（医学版）》2019年第2期190-195,共6页Journal of Tongji University(Medical Science)

基　　金：国家自然基金(81670690;81470991;81200492);上海市浦东新区卫计委重点学科项目(PWZxk2017-05);上海市浦江人才计划(13PJ1406900)

摘　　要：目的分析2型糖尿病患者中血清尿酸水平与缺血性脑卒中的关系。方法收集2018年1—12月住院的1 225例2型糖尿病患者,按尿酸水平由低到高将研究对象分为4组:尿酸Ⅰ组(男:血尿酸<300μmol/L,女:血尿酸<240μmol/L),尿酸Ⅱ组(男:300≤血尿酸<360μmol/L,女:240≤血尿酸<300μmol/L),尿酸Ⅲ组(男:360≤血尿酸<420μmol/L,女:300≤血尿酸<360μmol/L),尿酸Ⅳ组(男:血尿酸≥420μmol/L,女:血尿酸≥360μmol/L),分析不同尿酸水平的2型糖尿病患者中缺血性脑卒中的患病率,并采用Spearman相关性分析和多因素Logistic回归进一步探讨尿酸与缺血性脑卒中的相关性。结果在2型糖尿病合并高尿酸血症的患者(尿酸Ⅳ组)中,缺血性脑卒中的患病率为32. 68%(95%CI:27. 42%～37. 94%),明显高于低尿酸水平组(尿酸Ⅰ组)的14. 33%(95%CI:10. 41%～18. 25%)。Spearman相关性分析显示,2型糖尿病患者血清尿酸水平与缺血性脑卒中呈正相关(r=0. 237,P<0. 001)。多因素Logistic回归分析显示,在校正混杂因素后,2型糖尿病患者血清尿酸水平是缺血性脑卒中的独立危险因素(OR=1. 005,95%CI:1. 003～1. 007,P<0. 001)。结论血尿酸水平的升高是2型糖尿病患者发生缺血性脑卒中的独立危险因素。Objective To investigate the association between serum uric acid levels and ischemic stroke in patients with type 2 diabetes mellitus. Methods From January 2018 to December 2018, 1 225 patients with type 2 diabetes mellitus (T2DM) were enrolled in the study.Patients were divided into 4 groups according to serum uric acid (SUA) levels:quartile Ⅰ(male:SUA< 300 μmol/L ,female:SUA<240 μmol/L),quartile Ⅱ(male:300≤SUA<360 μmol/L,female:240≤SUA<300 μmol/L),quartile Ⅲ(male:360≤SUA<420 μmol/L,female:300≤SUA<360 μmol/L),quartile Ⅳ(male:SUA≥420 μmol/L,female:SUA≥360 μmol/L).The prevalence of ischemic stroke in T2DM patients with different SUA levels was analyzed.The Spearman's correlation analysis and multivariable logistic regression analysis was adopted to investigate the relationships between SUA and ischemic stroke. Results The prevalence of ischemic stroke in T2DM patients with hyperuricemia (quartile Ⅳ)(32.68%,95%CI:27.42%-37.94%) was significantly higher than T2DM patients with hypouricemia (quartile Ⅰ)(14.33%,95%CI:10.41%-18.25%).The Spearman's correlation analysis showed that the level of SUA was positively correlated with ischemic stroke ( r =0.237, P <0.001).Multivariate logistic regression analysis showed that SUA was an independent risk factor for ischemic stroke (OR=1.005,95%CI:1.003-1.007, P <0.001) in T2DM patients. Conclusion Serum uric acid is an independent risk factor for ischemic stroke in T2DM patients.

关 键 词：2型糖尿病 缺血性脑卒中 血尿酸 危险因素 患病率 

分 类 号：R692[医药卫生—泌尿科学]