2型糖尿病并急性脑梗死患者血尿酸水平与糖代谢及预后的关系  

The Relationship between Serum Uric Acid Level and Glucose Metabolism and Prognosis in Patients with Type 2 Diabetes and Acute Cerebral Infarction

作　　者：余艳会 YU Yanhui(The Second People’s Hospital of Neixiang County,He’nan Province 474350)

机构地区：[1]河南省内乡县第二人民医院,474350

出　　处：《医学理论与实践》2021年第19期3313-3316,共4页The Journal of Medical Theory and Practice

摘　　要：目的:探讨2型糖尿病(T2MD)并急性脑梗死患者血尿酸(SUA)水平与糖代谢、血浆致动脉硬化指数及预后的关系。方法:对我院2016年1月-2019年10月收治的192例T2MD并急性脑梗死患者的临床资料进行回顾性分析,依据30d改良rankin量表(mRS)得分进行分组,分为预后良好156例及预后不良36例,均检测基线SUA、糖代谢、甘油三酯(TG)和高密度脂蛋白胆固醇(HDL-C)水平、计算血浆致动脉硬化指数(AIP)。将基线SUA水平作为自变量分析影响T2MD并急性脑梗死患者预后的因素;分析SUA与糖代谢、AIP的相关性;绘制受试者工作特征曲线(ROC),分析SUA水平对预后不良的预测效能。结果:192例T2MD并急性脑梗死患者基线SUA水平为(463.57±45.22)μmol/L,FPG为(7.16±1.15)mmol,HbA1c为(8.71±1.63)%,AIP为0.59±0.15,预后不良发生率为18.75%;预后不良患者年龄>60岁、合并高血压、合并高脂血症、发病至入院时间>6h、基线SUA增高、FPG增高、HbA1c偏高、AIP偏高、饮酒、抽烟、大脑梗死面积者构成比均明显高于预后良好患者(P<0.05),经Logistic多元回归分析证实均为其独立危险因素;基线SUA水平与FPG、HbA1c、AIP均呈正相关性(P<0.05);基线SUA水平预测T2MD并急性脑梗死患者预后不良的最佳截断点为0.76,曲线下面积为0.911,95%CI为:0.871~0.926。结论:T2MD并急性脑梗死患者基线SUA水平高,FPG、HbA1c和AIP均偏高,且年龄>60岁、合并高血压等均是此类患者预后不良的危险因素。基线SUA水平与FPG、HbA1c、AIP均呈正相关,且对预后不良有良好的预测效能。Objective:To investigate the relationship between serum uric acid(SUA)level and glucose metabolism,plasma atherogenic indexes(AIP)and prognosis in patients with type 2 diabetes mellitus(T2MD)and acute cerebral infarction.Methods:The clinical data of 192 patients with T2MD and acute cerebral infarction admitted to the hospital from January 2016 to October 2019 were retrospectively analyzed.According to the 30 days improvedrankin scale(mRS)score,divided into 156 good prognosis and 36 poor prognosis,all detected for baseline SUA,glucose metabolism,triglyceride(TG)and high-density lipoprotein cholesterol(HDL-C)levels,and AIP was calculated.Baseline SUA level was used as an independent variable to analyze the factors affecting T2MD and prognosis in patients with acute cerebral infarction.The correlation between SUA and glucose metabolism and AIP was analyzed.The receiver operating characteristic curve(ROC)was drawn to analyze the predictive effect of SUA level on poor prognosis.Results:Baseline SUA levels in 192 patients with T2MD and acute cerebral infarction were(463.57±45.22)μmol/L,FPG was(7.16±1.15)mmol,HbA1c was(8.71±1.63)%,and AIP was 0.59±0.15,the incidence of adverse events was 18.75%.The proportions of age>60 years old,hypertension,hyperlipidemia,time from onset to admission>6 hours,increased baseline SUA,increased FPG,increased HbA1c,increased AIP,drinking,smoking and large cerebral infarction area in patients with poor prognosis were significantly higher than those in patients with good prognosis(P<0.05).Logistic multiple regression analysis confirmed that they were independent risk factors.Baseline SUA levels were positively correlated with FPG,HbA1c and AIP(P<0.05).The best cut-off point for predicting poor prognosis of patients with T2MD and acute cerebral infarction by baseline SUA level was 0.76,the area under curve was 0.911,and 95%CI was 0.871~0.926.Conclusion:The baseline SUA level of patients with T2MD complicated with acute cerebral infarction was high,FPG,HbA1c and AIP are increased,and the

关 键 词：2型糖尿病 急性脑梗死 血尿酸 糖代谢 血浆致动脉硬化指数 

分 类 号：R587.1[医药卫生—内分泌] R743.3[医药卫生—内科学]