血清尿酸水平与急性缺血性脑卒中患者静脉溶栓后出血转化的相关性研究  

Study on the Correlation between Serum Uric Acid Level and Hemorrhagic Transformation after Intravenous Thrombolysis in Acute Ischemic Stroke

作　　者：田宇轩 赵宗刚[1] 

机构地区：[1]济南市第五人民医院神经内科四病区,山东 济南

出　　处：《临床医学进展》2024年第9期894-902,共9页Advances in Clinical Medicine

摘　　要：目的:该研究旨在剖析静脉溶栓的急性缺血性卒中(acute ischemic stroke, AIS)患者体内血清尿酸(serum uric acid, SUA)水平和出血性转化(hemorrhagic transformation, HT)之间的相互关系。方法:对2020~2024年在院接受静脉溶栓治疗的急性大脑前循环缺血患者进行回顾性研究,在患者入院7天内通过颅脑CT检测出血性转化情况。比较HT组和非HT组之间以及根据欧洲合作急性卒中研究分类III (ECASS III)分类的不同类型HT组之间的基线资料、临床和实验室数据。结果:该研究共纳入701例AIS患者,其中102例发生HT,599例未发生HT。与非HT组的患者相比,HT组患者的尿酸(uric acid, UA)水平显著降低(251.85 ± 92.13 vs 307.73 ± 76.66, p Objective: To explore the relationship between SUA and HT after intravenous thrombolysis in patients with acute AIS. Methods: A retrospective analysis was performed on patients with anterior circulation AIS who received intravenous thrombolysis in the hospital from 2020 to 2024. HT was detected by brain CT or MRI within 7 days of admission. We compare baseline demographic, clinical, and laboratory data between the HT group and the non-HT group and between the different types of HT groups recorded according to the ECASS III. Results: 701 AIS patients who underwent intravenous rt-PA thrombolysis within 4.5 h after onset of AIS were divided into HT group (102) and Non-HT group (599). Compared with patients without HT, the UA level of HT patients was significantly reduced (251.85 ± 92.13 vs 307.73 ± 76.66, p < 0.01), but there was no significant difference between UA and HT types (p = 0.64). After adjusting for confounding factors, compared with the first quartile, the risk of HT in the fourth quartile was significantly reduced (OR 0.187, 95% CI 0.067~ 0.526, p = 0.001). Conclusion: Low levels of SUA may increase the risk of HT after intravenous thrombolysis.

关 键 词：尿酸 出血转化 静脉溶栓 急性脑卒中 

分 类 号：R74[医药卫生—神经病学与精神病学]