血清尿酸水平对急性缺血性脑卒中早期预后的影响  

Effect of serum uric acid level on early prognosis of acute ischemic stroke

作　　者：张毅 郭升[1] 武春桃 郑志勇[1] 张晶晶 赵文栋 苏静 ZHANG Yi;GUO Sheng;WU Chuntao;ZHENG Zhiyong;ZHANG Jingjing;ZHAO Wendong;SU Jing(The First Affiliated Hospital of Xinxiang Medical College,Xinxiang 453100,China)

机构地区：[1]新乡医学院第一附属医院,河南新乡453100

出　　处：《中国实用神经疾病杂志》2020年第22期1967-1972,共6页Chinese Journal of Practical Nervous Diseases

基　　金：河南省医学科技公关计划联合共建项目(编号2018020361,编号:2018020361)。

摘　　要：目的通过检测血清尿酸水平,探讨其对急性缺血性脑卒中早期预后的影响。方法收集2016-2018年新乡医学院第一附属医院收治的急性缺血性脑卒中患者203例,根据患者出院时的预后情况分为预后良好组(n=125)和预后不良组(n=78)。收集患者入院时的个人资料、实验室检测指标、血管相关危险因素及其他相关指标。采用独立样本t检验或卡方检验比较预后良好组与预后不良组的临床特征。单因素和多因素logistic回归模型分析影响急性缺血性脑卒中早期预后的因素。结果预后良好组与预后不良组TC、LDL、尿酸、尿素、NIHSS评分、格拉斯哥昏迷评分、住院时间、出院MRS评分比较差异具有统计学意义(P<0.05);多因素Logistic回归模型分析显示,发病至就诊时间(OR=1.124,95%CI0.963~1.547,P=0.041)、尿酸(OR=4.521,95%CI1.036~12.654,P=0.036)、NIHSS评分(OR=0.845,95%CI0.748~3.654,P=0.003)和出院MRS评分(OR=2.015,95%CI0.986~3.012,P=0.038)为影响急性缺血性脑卒中患者出院时预后不良的独立因素。结论预后不良组的血尿酸水平显著高于预后良好组,血尿酸水平升高为急性缺血性脑卒中早期预后不良的危险因素。Objective To investigate the effect of serum uric acid on the early prognosis of acute cerebral ischemic stroke.Methods A total of 203 patients with acute ischemic stroke admitted in our hospital from 2016 to 2018 were collected,including 135 males and 68 females.The average age was(60.2±10.7)years.According to the prognosis of patients at discharge,they were divided into good prognosis group(n=125)and poor prognosis group(n=78).Collect personal data,laboratory testing indicators,vascular-related risk factors,and other relevant indicators of patients at admission.Independent sample t test or chi-square test was used to compare the clinical characteristics of patients with good prognosis and those with poor prognosis.Univariate and multivariate Logistic regression models were used to analyze the factors affecting the early prognosis of acute cerebral ischemic stroke.Results The patients with good prognosis and those with poor prognosis had significant differences in TC,LDL,uric acid,urea,NIHSS score,Glasgow coma score,length of stay,and discharge MRS score(all P<0.05);Multivariate Logistic regression analysis showed that the time from onset to treatment(OR=1.124,95%CI0.963-1.547,P=0.041),uric acid(OR=4.521,95%CI1.036-12.654,P=0.036),NIHSS The scores(OR=0.845,95%CI 0.748-3.654,P=0.003)and discharge MRS scores(OR=2.015,95%CI0.986-3.012,P=0.038)are factors that affect patients with acute ischemic stroke when they are discharged.Risk factors for poor prognosis.Conclusion The serum uric acid level in patients with poor prognosis is significantly higher than that in the good prognosis group.Elevated blood uric acid is a risk factor for poor prognosis in the early stage of acute ischemic stroke.

关 键 词：急性缺血性脑卒中 血尿酸 LOGISTIC回归模型 短期预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]