早期血尿酸水平对不同性别首次急性缺血性卒中患者2年预后的影响因素研究  

Sex-specific Analysis of Influencing Factors for the Association between Baseline Serum Uric Acid and Two-year Outcome after First Acute Ischemic Stroke

作　　者：姚卉卉 舒琳 姚林利 李莎 杨晓童 李云春 YAO Huihui;SHU Lin;YAO Linli;LI Sha;YANG Xiaotong;LI Yunchun(Department of Clinical Nutrition,the University of Hong Kong-Shenzhen Hospital,Shenzhen 518048,China)

机构地区：[1]香港大学深圳医院临床营养科,广东省深圳市518048

出　　处：《中国全科医学》2023年第5期557-562,共6页Chinese General Practice

摘　　要：背景近年来研究表明,血尿酸(SUA)水平与急性缺血性卒中(AIS)患者的结局有关,但SUA对AIS患者是否具有正面影响仍然存在争议。目的探讨早期不同SUA水平与不同性别首次发生AIS的患者2年内复发及全因死亡情况的关系。方法回顾性选取2018-01-01至2019-12-31在香港大学深圳医院神经内科住院的首次发生AIS的患者。根据基线SUA水平的四分位数将AIS患者分为Q1组(n=129)、Q2组(n=129)、Q3组(n=128)、Q4组(n=127),收集患者住院期间的一般信息、生化指标及2年内不良结局情况(复发和全因死亡),随访截至2021-12-31。通过Logistic回归分析探究基线SUA水平与AIS患者2年内不良结局的关系。结果单因素Logistic回归分析结果显示,高龄、糖尿病史、慢性肾功能不全史、空腹血糖及三酰甘油水平高是男性AIS患者2年内复发和全因死亡的危险因素(P<0.05);高龄、糖尿病史是女性AIS患者2年内复发和全因死亡的危险因素(P<0.05)。多因素Logistic回归分析结果显示,调整各种因素后,男性Q4组出现复发和全因死亡的风险低于Q1组〔OR=0.187,95%CI(0.035,0.990),P<0.05〕。结论相较于较低水平SUA,较高水平的SUA与男性首次发生AIS患者2年内复发及全因死亡率低有关,中间水平SUA与男性首次发生AIS患者2年内复发及全因死亡率低无关。Background The level of serum uric acid(SUA)has recently been proven to be associated with outcomes in patients with acute ischemic stroke(AIS),but whether the association is still controversial.Objective To explore the relationship of baseline SUA level with two-year recurrence and all-cause mortality after first AIS.Methods This retrospective study was conducted with a cohort of inpatients with first AIS treated in Department of Neurology,University of Hong Kong-Shenzhen Hospital from January 1,2018 to December 31,2019.The general information,biochemical indicators,and two-year adverse outcome(recurrence and all-cause mortality)after first AIS were collected and a follow up until December 31,2021.Logistic regression analysis was used to explore the relationship of adverse outcome with quartile of baseline SUA levels〔Q1 group(n=129),Q2 group(n=129),Q3 group(n=128),Q4 group(n=127)〕by sex.Results Univariate Logistic regression analysis showed that advanced age,history of diabetes,history of chronic renal insufficiency,high fasting blood glucose and triglyceride levels were risk factors for two-year recurrence and all-cause mortality after first AIS in male patients(P<0.05).And advanced age and history of diabetes were risk factors for two-year recurrence and all-cause mortality after first AIS in female patients(P<0.05).Multivariate Logistic regression analysis showed that the risk of two-year recurrence and all-cause mortality in males in Q4 group was lower than that of those in Q1 group〔OR=0.187,95%CI(0.035,0.990),P<0.05〕after adjusting for various confounding factors.Conclusion Higher baseline level of SUA was associated with lower two-year recurrence and all-cause mortality in male patients after first AIS compared to lower baseline level SUA.while intermediate baseline level of SUA was not associated with.

关 键 词：脑梗死 尿酸 复发 全因死亡 脑疾病 预后 影响因素分析 卒中 

分 类 号：R743.33[医药卫生—神经病学与精神病学]