血清尿酸浓度水平与脑梗死患者预后的关系研究

The relationship of the serum uric acid concentration and prognosis of patients with cerebral infarction

目的通过对血清尿酸浓度进行检测,探讨血清尿酸浓度水平与脑梗死患者预后的关系。方法将2008～2011年本院收治的70例急性脑梗死患者资料进行回顾性分析,全部患者分为正常尿酸组和高尿酸组,各35例。结果正常尿酸组血尿酸浓度为(327.3±76.4)μmol/L,高尿酸组血尿酸浓度为(478.5±94.5)μmol/L。正常尿酸组入院时Barthel评分为(44.4±12.2)分,出院时Barthel评分为(78.5±14.9)分,出院时Barthel评分高于入院时,差异有统计学意义(P<0.05)。高尿酸组入院时Barthel评分为(22.1±13.8)分,出院时Barthel评分为(45.5±12.9)分,出院时Barthel评分高于入院时,差异有统计学意义(P<0.05)。进行Logistic多因素回归分析血尿酸与患者出院时Barthel评分的相关性,结果显示两者呈负相关(r=-1.35,OR=0.27,P<0.05),血尿酸浓度水平越高,脑梗死患者的预后越差。结论高尿酸血症是急性脑梗死早期预后不良的危险因素,可作为评估预后的参考指标,血尿酸浓度越高,预后越差,故在脑梗死患者的治疗过程中应当同时采用降低患者血尿酸浓度水平的措施,以改善预后。

Objective To explore the relationship between the level of serum uric acid concentrations and prognosis of patients with cerebral infarction by detection of serum uric acid concentration. Methods The data of 70 cases of patients with acute cerebral infarction in our hospital from 2008 to 2011 were retrospectively analyzed and divided into normal uric acid group and high uric acid group. Results Serum uric acid of normal uric acid group was （327.3±76.4） μmol/L and that of high uric acid group was （478.5±94.5） μmol/L. Barthel score of normal uric acid group was （44.4±12.2）points before treatment and （78.5±14.9） points after treatment. Barthel score of normal uric acid group after treatment was significantly higher than it before treatment （P 0.05）. Barthel score of high uric acid group was（22.1±13.8） points before treatment and （45.5±12.9） points after treatment. Barthel score of high uric acid group after treatment was significantly higher than it before treatment（P 0.05）. The result of logistic regression analysis of multiple factors with the patient＇s discharge Barthel scores showed that serum uric acid level in patients with acute cerebral infarction was negatively correlated with discharged Barthel scores（r = -1.35, OR=0.27,P 0.05）. The higher the level of serum uric acid was, the worse the prognosis of patients with cerebral infarction was. Conclusion Hyperuricemia is a risk factor for early poor prognosis in cerebral infarction and can be used as a reference to assess the prognostic indicators. The higher the level of serum uric acid is, the worse the prognosis is. To reduce the level of serum uric acid in the treatment of patients with cerebral infarction can improve the prognosis.