血尿酸及胱抑素C与急性缺血性脑卒中发病及预后的相关性研究  

Research on the correlation between the levels of serum uric acid with cystatin C and the pathogenesis and prognosis of acute ischemic stroke

作　　者：王一鸣 寇雪莲[1] 戴方瑜[1] 王斌达[1] 何松彬[1] WANG Yiming;KOU Xuelian;DAI Fangyu;WANG Binda;HE Songbin(Department of Neurology,Zhoushan Hospital in Zhejiang Province,Zhoushan 316000,China)

机构地区：[1]浙江省舟山医院神经内科,浙江舟山316000

出　　处：《中国现代医生》2020年第33期68-72,共5页China Modern Doctor

基　　金：浙江省科技计划项目(2017C33188);浙江省舟山市科技计划项目(2018C11044)。

摘　　要：目的探讨急性缺血性脑卒中患者尿酸和胱抑素C水平与疾病严重程度和短期预后等的关系。方法选取浙江省舟山医院2018年1~12月间收入院的80例急性缺血性脑卒中患者进行回顾性分析,按美国国立卫生研究院卒中量表(National institute of health stroke scale,NIHSS)评分将患者分为高、中、低三组及按影像学检查脑梗死的面积分为大、中、小面积脑梗死三组,并于入院后24 h完善尿酸、胱抑素C检测,将各组尿酸及胱抑素C的水平进行比较;通过入院及治疗2周后两次NIHSS评分变化情况评估患者预后情况,比较尿酸及胱抑素C水平的高低与患者预后情况的关系;分析尿酸与胱抑素C指标的内在相关性。结果(1)高NIHSS评分患者的尿酸及胱抑素C水平均高于相对低NIHSS评分患者(P<0.05),且NIHSS评分与尿酸、胱抑素C水平呈正相关(均P<0.05)。(2)大面积脑梗死患者的尿酸及胱抑素C水平高于中、小面积脑梗死患者(P<0.05),中面积脑梗死患者也高于小面积脑梗死的患者。(3)急性缺血性脑卒中患者的尿酸及胱抑素C水平随预后不同存在差异,但仅尿酸表现为疾病预后越良好(NIHSS评分改善),尿酸水平越高。结论尿酸及胱抑素C水平与急性缺血性脑卒中疾病严重程度密切相关,而在急性缺血性脑卒中患者中尿酸升高可能预示着神经功能有着更良好的结局。Objective To explore the correlation between the levels of serum uric acid with cystatin C and disease severity and short-term prognosis in patients with acute ischemic stroke.Methods A total of 80 patients with acute ischemic stroke admitted to Zhoushan Hospital in Zhejiang Province from January to December 2018 were selected and retrospectively analyzed.According to the National Institute of Health Stroke Scale(NIHSS),the patients were divided into the high score group,the medium score group and the low score group.Meanwhile,according to the area of cerebral infarction examined by medical imaging,the patients were divided into the large area of cerebral infarction group,the medium area of cerebral infarction group and the small area of cerebral infarction group.The detection of the levels of uric acid and cystatin C was improved 24 hours after admission,and the levels of uric acid and cystatin C in each group were compared.The prognosis of patients was evaluated by the changes of NIHSS scores after admission and 2 weeks of treatment,and the correlation between the levels of uric acid and cystatin C and the prognosis of patients was compared.The inner correlation between uric acid and cystatin C indexes was analyzed.Results(1)The levels of uric acid and cystatin C in patients with high NIHSS score were higher than those in patients with relatively low NIHSS score(P<0.05),and NIHSS score was positively correlated with the levels of uric acid and cystatin C(all P<0.05).(2)The levels of uric acid and cystatin C in patients with large area of cerebral infarction were higher than those in patients with medium and small area of cerebral infarction(P<0.05),and those in patients with moderate area of cerebral infarction were also higher than those in patients with small area of cerebral infarction.(3)The levels of uric acid and cystatin C in patients with acute ischemic stroke were different with prognosis discrepancy,but only uric acid showed that the better the prognosis(NIHSS score improved),the higher the level of u

关 键 词：急性缺血性脑卒中 尿酸 胱抑素C NIHSS评分 脑梗死面积 

分 类 号：R743.3[医药卫生—神经病学与精神病学]