血清尿酸/白蛋白比值与大动脉粥样硬化性卒中及其严重程度和短期转归的相关性  

Correlation between serum uric acid/albumin ratio and large atherosclerosis stroke,its severity and short-term outcome

作　　者：赵洁[1] 朱晓岩[2] 张萌[1] 徐卿 潘旭东[1] Zhao Jie;Zhu Xiaoyan;Zhang Meng;Xu Qing;Pan Xudong(Department of Neurology,the Affiliated Hospital of Qingdao University,Qingdao 266000,China;Department of Critical Care Medicine,the Affiliated Hospital of Qingdao University,Qingdao 266000,China)

机构地区：[1]青岛大学附属医院神经内科,青岛266000 [2]青岛大学附属医院重症医学科,青岛266000

出　　处：《国际脑血管病杂志》2023年第5期332-338,共7页International Journal of Cerebrovascular Diseases

摘　　要：目的探讨血清尿酸/白蛋白比值(uric acid to albumin ratio,UAR)与大动脉粥样硬化性卒中(large artery atherosclerosis,LAA)及其严重程度和短期转归的相关性。方法回顾性纳入2017年9月至2022年8月在青岛大学附属医院神经内科住院的急性缺血性卒中患者,根据TOAST病因学分型标准分为LAA和非LAA。对于LAA患者,根据入院时美国国立卫生研究院卒中量表评分进一步分为轻度卒中组(≤8分)和中重度卒中组(>8分),根据出院时改良Rankin量表评分进一步分为转归良好组(≤2分)和转归不良组(>2分)。采用多变量logistic回归分析确定UAR与LAA及其严重程度和短期转归的相关性。通过受试者工作特征(receiver operating characteristic,ROC)曲线评估UAR对LAA患者转归不良的预测价值。结果共纳入4178例急性缺血性卒中患者,男性2751例(65.8%),年龄(61.95±10.73)岁。LAA 2000例(47.9%),其中轻度卒中1112例(55.6%),中重度卒中888例(44.4%);短期转归良好813例(40.65%),转归不良1187例(59.35%)。LAA组UAR显著高于非LAA组(P<0.05);在LAA患者中,中重度卒中组和短期转归不良组UAR分别显著高于轻度卒中组和短期转归良好组(P均<0.05)。多变量logistic回归分析显示,UAR是LAA[优势比(odds ratio,OR)1.043,95%置信区间(confidence interval,CI)1.016~1.071;P=0.002]及其严重程度(OR 2.000,95%CI 1.860~2.151;P<0.001)和短期转归不良(OR 1.456,95%CI 1.379~1.537;P<0.001)的独立危险因素。ROC曲线分析显示,UAR预测LAA患者短期转归不良的曲线下面积为0.727(95%CI 0.704~0.750;P<0.001),最佳截断值为6.62,敏感性和特异性分别为86.6%和56.7%。UAR预测LAA患者短期转归不良的曲线下面积均大于尿酸和白蛋白单独预测。结论UAR与LAA及其严重程度及转归不良有关,并且对LAA患者转归不良具有较高的预测价值。Objective To investigate the correlation between serum uric acid to albumin ratio(UAR)and large-artery atherosclerosis(LAA),its severity and short-term outcome.Methods Patients with acute ischemic stroke admitted to the Department of Neurology,the Affiliated Hospital of Qingdao University from September 2017 to August 2022 were retrospectively enrolled.They were classified into LAA and non-LAA according to the TOAST etiological criteria.Patients with LAA were further divided into mild stroke group(≤8)and moderate to severe stroke group(>8)according to the National Institutes of Health Stroke Scale score at admission,and good outcome group(≤2)and poor outcome group(>2)according to the modified Rankin Scale score at discharge.Multivariate logistic regression analysis was used to determine the correlation between UAR and LAA,its severity and short-term outcome.The predictive value of UAR for poor outcomes in patients with LAA was evaluated by receiver operating characteristic(ROC)curve.Results A total of 4178 patients with acute ischemic stroke were enrolled,including 2751 males(65.8%),aged 61.95±10.73 years.There were 2000(47.9%)patients with LAA,including 1112(55.6%)mild stroke and 888(44.4%)moderate to severe stroke;813(40.65%)had good short-term outcomes and 1187(59.35%)had poor outcomes.UAR in the LAA group was significantly higher than that in the non-LAA group(P<0.05).In patients with LAA,the UAR of the moderate to severe stroke group and the short-term poor outcome group were significantly higher than that of the mild stroke group and the short-term good outcome group,respectively(all P<0.05).Multivariate logistic regression analysis showed that the UAR was an independent risk factor for LAA(odds ratio[OR]1.043,95%confidence interval[CI]1.016-1.071;P=0.002),its severity(OR 2.000,95%CI 1.860-2.151;P<0.001),and short-term poor outcomes(OR 1.456,95%CI 1.379-1.537;P<0.001).ROC curve analysis showed that the area under the curve of UAR for predicting short-term poor outcomes in patients with LAA was 0.727(95

关 键 词：缺血性卒中 动脉粥样硬化 尿酸 血清白蛋白 疾病严重程度指数 治疗结果 试验预期值 

分 类 号：R743.3[医药卫生—神经病学与精神病学]