前后循环急性缺血性卒中患者血尿酸的变化及预后分析  

Detection and prognosis analysis of serum uric acid in patients with anterior and post circulation acute ischemic stroke

作　　者：许翠萍 琚双五[1] XU Cui-ping;JU Shuang-wu(Department of Neurology, Chizhou People′s Hospital, Chizhou Anhui 247000, China)

机构地区：[1]池州市人民医院神经内科

出　　处：《江苏大学学报（医学版）》2019年第6期511-515,共5页Journal of Jiangsu University：Medicine Edition

摘　　要：目的:检测前后循环急性缺血性卒中(acute ischemic stroke,AIS)患者血尿酸的变化,并探讨其预后意义。方法:收集141例AIS患者的临床资料,根据损伤部位将其分为前循环组和后循环组,测患者血尿酸水平、Barthel指数、神经功能缺损(neurologic impairment score,NIS)评分,并采用Pearson相关分析血尿酸水平与Barthel指数、NIS评分的相关性;根据随访情况分为预后良好组和预后不良组,采用多因素Logistic回归分析影响前后循环AIS患者预后不良的危险因素。结果:经Pearson相关性分析,前后循环组血尿酸水平与Barthel指数均呈显著负相关(r=-0. 832、-0. 801,P=0. 002、0. 005),与NIS评分均呈显著正相关(r=0. 874、0. 885,P=0. 000、0. 000);前后循环预后不良组年龄、发病至溶栓时间> 4. 5 h、入院高血尿酸症、Barthel指数<60分、NIS> 12分患者构成比均高于预后良好组,且差异均有统计学意义(P <0. 05);经Logistic回归分析,年龄≥60岁、发病至溶栓时间> 4. 5 h、入院高血尿酸血症、Barthel指数<60分、NIS评分> 12分均是影响前后循环AIS患者预后不良的独立危险因素(P <0. 05)。结论:前后循环AIS患者中血尿酸的变化与患者自理能力、神经功能缺损程度关系密切,可作为判断预后的参考指标。Objective: To detect the changes of serum uric acid in patients with anterior and post circulation acute ischemic stroke (AIS), and to explore its prognosis significance. Methods: The clinical data of 141 patients with AIS were analyzed retrospectively. They were divided into the anterior circulation group and the posterior circulation group according to the injury site. The levels of serum uric acid, Barthel index (BI), and neurological deficit (NIS) were measured, and the correlation between serum uric acid level and BI index or NIS score was analyzed by Pearson correlation analysis. The patients were divided into good prognosis group and bad prognosis group according to their prognosis. Risk factors for poor prognosis in patients with anterior and posterior circulation AIS were determined by multivariate logistic regression analysis. Results: According to Pearson correlation analysis, there was a significant negative correlation between serum uric acid level and BI index in the anterior and posterior circulation groups (r=-0.832, -0.801, P=0.002, 0.005), while there was a significant positive correlation between serum uric acid level and NIS score in the anterior and posterior circulation groups (r=0.874, 0.885, P=0.000, 0.000). There were no significant differences in the proportion of sex, smoking history, past transient ischemic attack history, hypertension, coronary heart disease, hyperlipidemia, atrial fibrillation, diffuse intravascular coagulation branch number and the proportion of patients receiving cranial valve decompression between the good and bad prognosis groups (P>0.05), while the proportion of age over or equal to 60 years old, duration from onset to thrombolysis more than 4.5 hours, admission hyperuricemia, BI index below 60 points, NIS score higher than 12 points,were higher than those with good prognosis (P<0.05). Logistic regression analysis showed that age over or equal to 60 years old, duration from onset to thrombolysis more than 4.5 hours, admission hyperuricemia, BI index below 60 poi

关 键 词：前后循环 急性缺血性卒中 血尿酸 BARTHEL指数 神经功能缺损评分 

分 类 号：R743.34[医药卫生—神经病学与精神病学]