血清尿酸与青年缺血性卒中患者颈动脉斑块及其稳定性的相关性  

Associations of serum uric acid with carotid artery plaques and their stability in young patients with ischemic stroke

作　　者：余年[1] 张燕芳[1] 林兴建[1] 狄晴[1] Yu Nian;Zhang Yanfang;Lin Xingjian;Di Qing(Brain Hospital Affiliated to Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学附属脑科医院,南京210029

出　　处：《国际脑血管病杂志》2024年第2期106-110,共5页International Journal of Cerebrovascular Diseases

基　　金：2021年度“健康中国·步长致远心脑健康公益工程”科研项目。

摘　　要：目的探讨血清尿酸对青年缺血性卒中患者颈动脉斑块形成及稳定性的影响。方法回顾性连续纳入2013年1月至2021年12月期间南京医科大学附属脑科医院收治的青年缺血性卒中患者。依据入院时颈动脉超声检查结果分为无斑块组和斑块组,后者进一步分为稳定斑块组和易损斑块组。应用多变量logistic回归分析确定血清尿酸与颈动脉斑块形成及稳定性的相关性。结果共纳入361例青年缺血性卒中患者,男性291例(80.6%),年龄(35.45±6.29)岁,84例(23.3%)存在颈动脉斑块,其中45例(53.6%)为易损斑块。斑块组有高血压史、精神心理病史和高尿酸血症的患者比例以及空腹血糖、总胆固醇和低密度脂蛋白胆固醇、血清尿酸显著高于无斑块组(P均<0.05);易损斑块组血清尿酸显著高于稳定斑块组(P=0.004)。多变量logistic回归分析显示,血清尿酸较高是颈动脉斑块不稳定的独立危险因素(优势比1.009,95%置信区间0.997~1.022;P=0.003),但与颈动脉斑块形成无显著独立相关性。结论血清尿酸较高可能与青年缺血卒中患者颈动脉斑块的易损性相关。Objective To investigate the effect of serum uric acid on the formation and stability of carotid artery plaques in young patients with ischemic stroke.Methods Consecutive young patients with ischemic stroke admitted to Brain Hospital Affiliated to Nanjing Medical University from January 2013 to December 2021 were included retrospectively.According to the result of carotid ultrasound examination at admission,patients were divided into non-plaque group and plaque group.The latter was further divided into a stable plaque group and vulnerable plaque group.Multivariate logistic regression analysis was to determine the association of serum uric acid with carotid plaque formation and stability.Results A total of 361 young patients with ischemic stroke were enrolled,including 291 males(80.6%)with an age of 35.45±6.29 years.Eighty-four patients(23.3%)had carotid artery plaques,of which 45(53.6%)were vulnerable plaques.The proportion of patients with a history of hypertension,mental illness,and hyperuricemia,as well as fasting blood glucose,total cholesterol,low-density lipoprotein cholesterol,and serum uric acid in the plaque group were significantly higher than those in the non-plaque group(all P<0.05).The serum uric acid in the vulnerable plaque group was significantly higher than that in the stable plaque group(P=0.004).Multivariate logistic regression analysis showed that higher serum uric acid was an independent risk factor for unstable carotid artery plaques(odds ratio 1.009,95%confidence interval 0.997-1.022;P=0.003),but there was no significant independent correlation with carotid artery plaque formation.Conclusion Higher serum uric acid may be associated with the vulnerability of carotid artery plaques in young patients with ischemic stroke.

关 键 词：缺血性卒中 颈动脉狭窄 动脉粥样硬化 斑块 动脉粥样硬化 尿酸 危险因素 年轻人 

分 类 号：R743.31[医药卫生—神经病学与精神病学]