血清尿酸水平与癫痫持续状态严重程度及短期预后的关系研究  

Association of serumuric acid with the severity of status epilepticus and short-term outcome

作　　者：颜慧蓉 陈哲萌 徐雅敏 何燕艳 YAN Huirong;CHEN Zhemeng;XU Yamin;HE Yanyan(Department of Neurology,Jiaxing First Hospital,Jiaxing 314000,China)

机构地区：[1]嘉兴市第一医院神经内科,314000

出　　处：《心电与循环》2025年第2期168-172,共5页Journal of Electrocardiology and Circulation

基　　金：嘉兴市科技计划项目(2022AD30063)。

摘　　要：目的探讨血清尿酸水平与癫痫持续状态(SE)严重程度、短期预后的关系。方法回顾性选择2018年1月至2022年12月在嘉兴市第一医院确诊SE的患者131例,根据入院时SE严重程度评分(STESS)将患者分为STESS<3分86例及STESS≥3分45例,比较两组患者血清尿酸水平,采用Pearson相关分析血清尿酸水平与SE严重程度的关系。以出院结局反映短期预后,将患者分为预后良好组[格拉斯哥预后量表(GOS)评分3~5分]101例及预后不良组(GOS评分1~2分)30例。采用多因素logistic回归分析SE患者短期预后的危险因素,绘制ROC曲线分析血清尿酸及相关指标对短期预后的预测效能。结果STESS≥3分患者血清尿酸水平为(474.02±182.24)滋mol/L,高于STESS<3分患者的(347.96±159.26)滋mol/L,差异有统计学意义(P<0.001)。Pearson相关分析显示SE患者血清尿酸水平与STESS呈正相关(r=0.321,P<0.001)。预后不良患者查尔森合并症指数(CCI)≥3分、STESS≥3分的比例及血清尿酸水平高于预后良好患者,差异均有统计学意义(均P<0.05)。多因素logistic回归分析显示血清尿酸、CCI、STESS是SE患者短期预后不良的独立危险因素(均P<0.05)。ROC曲线分析显示,三者联合对SE患者短期预后的预测效能高于血清尿酸、CCI、STESS单独预测(三者联合AUC=0.935,均P<0.05)。结论血清尿酸水平与SE严重程度及短期预后相关。Objective To investigate the association of serum uric acid with the severity and short-term outcome of status epilepticus(SE).Methods A total of 131 patients diagnosed with SE in Jiaxing First Hospital from January 2018 to December 2022 were retrospectively selected.According to Status Epilepticus Severity Score(STESS)at admission,the patients were divided into STESS<3 and STESS≥3.Serum uric acid was compared between the two groups.Pearson correlation was used to analyze the relationship between serum uric acid and the severity of SE.The short-term outcome was determined based on the discharge status.The patients were divided into 101 patients with better outcome[Glasgow Outcome Scale(GOS)score 3-5 points]and 30 patients with poor outcome(GOS score 1-2 points).Multivariate logistic regression was used to analyze the risk factors for short-term outcome of adults with SE.ROC curve was drawn to analyze the predictive efficacy of serum uric acid and related factors for short-term outcome.Results The serum uric acid in patients with STESS≥3 was(474.02±182.24)滋mol/L,significantly higher than that in patients with STESS<3(347.96±159.26)滋mol/L(t=3.922,P<0.001).Pearson correlation analysis showed that serum uric acid in SE patients was positively correlated with STESS(r=0.321,P<0.001).The proportion of Charlson comorbidity index(CCI)≥3 and STESS≥3,and serum uric acid were significantly higher in patients with poor outcome than in patients with better outcome(all P<0.05).Multivariate logistic regression analysis showed that serum uric acid,CCI and STESS were independent risk factors for poor short-term outcome(all P<0.05).ROC curve analysis showed that the combination of the three factors had a higher predictive power for short-term outcome in SE patients than serum uric acid,CCI,and STESS alone(AUC=0.935,all P<0.05).Conclusion Serum uric acid is related to the severity and short-term outcome of SE.

关 键 词：癫痫持续状态 尿酸 预后 

分 类 号：R742.1[医药卫生—神经病学与精神病学]