血清尿酸水平与急性脑出血患者神经功能缺损程度的相关性研究  

Study on the correlation between serum uric acid level and the degree of neurological deficit in patients with acute cerebral hemorrhage

作　　者：孙彦杰[1] 刘娜[2] 李欣[3] 段瑞生[4] SUN Yanjie;LIU Na;LI Xin;DUAN Ruisheng(The Second Hospital of Hebei Medical University,Shijiazhuang 050000,Hebei,China;Shijiazhuang Medical College,Shijiazhuang 050000,Hebei,China;Shijiazhuang Great Wall Hospital of Integrated Traditional Chinese and Western Medicine,Shijiazhuang 050000,Hebei,China;Hebei General Hospital,Shijiazhuang 050000,Hebei,China)

机构地区：[1]河北医科大学第二医院,河北石家庄050000 [2]石家庄医学高等专科学校,河北石家庄050000 [3]石家庄长城中西医结合医院,河北石家庄050000 [4]河北省人民医院,河北石家庄050000

出　　处：《现代中西医结合杂志》2021年第31期3468-3471,共4页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：河北省医学科学研究重点课题计划项目(20180340)。

摘　　要：目的探究血清尿酸(SUA)水平与急性脑出血患者病情严重程度的相关性,为急性脑出血的防治提供理论依据。方法选取河北医科大学第二医院2013年12月—2017年12月收治的急性脑出血患者47例作为脑出血组,再依据美国国立卫生研究院卒中量表评分标准将患者分为轻度组(NIHSS评分0~3分)、中度组(NIHSS评分4~15分)、重度组(NIHSS评分15分以上);另选取同期性别、年龄相近的健康体检者81例作为健康组。测量所有受检者血压[收缩压(SBP)、舒张压(DBP)],并抽取晨起空腹6h以上静脉血检测SUA、血糖(FPG)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1(Apo A1)、载脂蛋白B(Apo B)、血浆纤维蛋白原(FIB)水平,比较脑出血组患者和健康组血压及各项化验指标的差异,对不同程度脑出血患者的SUA水平进行比较分析,Pearson相关分析SUA水平与NIHSS评分的相关性,Logistic回归分析上述所有检测指标与脑出血的关系。结果脑出血组患者SBP、DBP及FPG、TC、TG、Apo B、SUA水平均明显高于健康组(P均<0.05),Apo A1水平明显低于健康组(P<0.05)。轻度组、中度组、重度组SUA水平分别为(260.84±32.34)μmol/L、(331.72±38.59)μmol/L、(360.10±29.80)μmol/L,SUA水平随分度加重而逐渐升高,各组间比较差异均有统计学意义(P均<0.05)。Pearson相关分析显示SUA水平与脑出血患者神经功能缺损程度呈正相关(r=0.556,P<0.05)。调整混杂和影响因素后,Logistic回归分析显示SUA是急性脑出血的危险因素[OR=3.106,95%CI(1.408,5.382),P<0.05]。结论SUA是急性脑出血的独立危险因素,其水平与病情严重程度呈正相关,水平越高病情越重,对指导治疗和判断预后有重要价值。Objective It is to explore the correlation between serum uric acid(SUA)level and the severity of acute cerebral hemorrhage in order to provide a theoretical basis for the prevention and treatment of acute cerebral hemorrhage.Methods A total of 47 patients with acute cerebral hemorrhage admitted to the Second Hospital of Hebei Medical University from December 2013 to December 2017 were selected as the cerebral hemorrhage group,and the patients were divided into mild groups according to the scoring standard of the National Institutes of Health Stroke Scale(0 to 3 points of NIHSS score),moderate group(4 to 15 points of NIHSS score),severe group(15 or more points of NIHSS score);81 cases of healthy persons with similar gender and age were selected as the healthy group.The blood pressure[systolic blood pressure(SBP),diastolic blood pressure(DBP)]of all subjects was measured,and the venous blood after empty stomach for more than 6 hours was taken in the morning to detect the levels of SUA,fasting plasma glucose(FPG),total cholesterol(TC),triacylglycerol(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),apolipoprotein A1(Apo A1),apolipoprotein B(Apo B),plasma fibrinogen(FIB),the differences in blood pressure and various laboratory indicators between the cerebral hemorrhage group and the healthy group were compared,and the SUA level of patients with different degrees of cerebral hemorrhage was analyzed.Pearson correlation analysis was used to analyze the correlation between SUA level and NIHSS score,Logistic regression analysis was used to analyze the relationship between all the above detection indicators and brain hemorrhage.Results The levels of SBP,DBP,FPG,TC,TG,Apo B,and SUA in the cerebral hemorrhage group were significantly higher than those in the healthy group(all P<0.05),and the levels of Apo A1 was significantly lower than that in the healthy group(P<0.05).The levels of SUA in the mild,moderate,and severe groups were(260.84±32.34)μmol/L,(331.72±38.59)μmol/L,and(360.

关 键 词：脑出血 血尿酸 神经功能缺损 

分 类 号：R743.34[医药卫生—神经病学与精神病学]