尿酸与急性缺血性脑卒中早期预后关系的研究  

Relationship between serum UA level and early outcome in acute ischemic stroke patients

作　　者：郝美美[1] 陈晨[2] 袁兴运[2] 霍康[2] 韩建峰[2] 宋文锋[2] Hao Meimei;Chen chen;Yuan Xingyun;Huo Kang;Han Jianfeng;Song Wenfeng(Department of Neurology,Yan..an People..s Hospital,Yan..an 716000,Shaanxi Province,China)

机构地区：[1]延安市人民医院神经内科,716000 [2]西安交通大学第一附属医院神经内科

出　　处：《中华老年心脑血管病杂志》2019年第5期515-518,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨血清尿酸与急性缺血性脑卒中早期预后的关系。方法选择2015年3月～2016年3月西安交通大学第一附属医院神经内科连续住院治疗的急性缺血性脑卒中患者421例,根据出院时预后情况分为预后良好组232例[改良的Rankin评分(modified Rankin scale,mRS)0～2分],预后不良组189例(mRS 3～6分)。采集整理患者入院时人口学信息、血管相关危险因素、尿酸等实验室指标、影像学资料及疾病相关临床指标,包括美国国立卫生研究院卒中量表(national institutes of health stroke scale,NIHSS)评分。对2组患者上述临床特点进行比较,并通过非条件logistic回归分析尿酸与急性缺血性脑卒中早期预后的关系。结果预后不良组心房颤动、收缩压、TC、LDL、尿素、NIHSS评分、脑梗死位于大脑前动脉及大脑中动脉、住院时间、死亡和出院mRS评分明显高于预后良好组,尿酸和格拉斯哥昏迷评分明显低于预后良好组,差异有统计学意义(P<0.05,P<0.01)。非条件logistic回归分析显示,收缩压、NIHSS评分和尿酸为急性缺血性脑卒中患者预后不良的主要因素(OR=1.017,95%CI:1.003～1.031,P=0.018;OR=1.274,95%CI:1.178～1.378,P=0.000;OR=0.993,95%CI:0.989～0.996,P=0.000)。结论血清低尿酸可能与急性缺血性脑卒中早期预后不良相关。Objective To study the relationship between serum UA level and early outcome in acute ischemic stroke(AIS)patients.Methods Four hundred and twenty-one AIS patients admitted to the First Affiliated Hospital of Xi'an Jiaotong University from March 2015 to March 2016 were divided into good outcome group(n=232)and poor outcome group(n=189)according to their modified Rankin scale(mRS)score.Their demographic data,risk factors for vascular disease, laboratory testing parameters,imaging and clinical data and NIHSS score were recorded and compared.The relationship between serum UA level and early poor outcome in AIS patients was analyzed by unconditioned logistic regression analysis.Results The incidence of AF and cerebral infarction in the territory of anterior cerebral artey and middle cerebral artery,SBP,serum TC, LDL and urea levels,NIHSS and mRS score,and mortality were significantly higher and the hospital stay time was significantly longer while the serum UA level and GCS score were significantly lower in poor outcome group than in good outcome group(P<0.05,P<0.01).Unconditioned logistic regression analysis showed that SBP,NIHSS score and serum UA level were the major risk factors for the early poor outcome in AIS patients(OR=1.017,95%CI:1.003-1.031,P= 0.018;OR=1.274,95%CI:1.178-1.378,P=0.000;OR=0.993,95%CI:0.989-0.996,P= 0.000).Conclusion The low serum UA level is related with the early poor outcome in AIS patients.

关 键 词：尿酸 卒中 心房颤动 冠状动脉疾病 大脑中动脉 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]