血尿酸与急性缺血性脑卒中TOAST分型及早期预后的相关性研究

Relationship Between Serum Uric Acid and TOAST Subtypes with Acute Ischemic Stroke and Early-Term Prognosis

目的探讨血尿酸与不同分型急性缺血性脑卒中及患者早期预后的相关性。方法将225例急性缺血性脑卒中患者纳入病例组,212例同期在我院体检中心的健康体检患者纳入对照组,病例组按照TOAST(trial of org10172 in acute stroke treatment)分型标准进行分型,均检测血尿酸水平,分析不同血尿酸水平与急性缺血性脑卒中TOAST分型的关系。根据血尿酸水平将缺血性脑卒中患者分为高尿酸组和正常尿酸组,采用NIHSS评分和Barthel Index(BI)评分于患者入院、出院时对其神经功能缺损程度和日常生活能力(ADL)进行评定,比较两组间NIHSS评分和BI评分的差异。结果病例组血清尿酸高于对照组(P<0.01),大动脉粥样硬化型、小动脉闭塞型血尿酸水平高于心源性脑栓塞型、其他明确病因型、不明原因型,差异具有统计学意义(P<0.01)。与正常尿酸组对比,高血尿酸组患者入院时、出院时的NIHSS评分和BI评分差异均有统计学意义(P<0.05)。结论血尿酸水平对急性缺血性脑卒中的TOAST分型具有一定的提示作用,而且与患者早期预后有关,尿酸水平越高,预后越差。

Objective To study the relationship between serum uric acid and different etiological subtype with acute ischemic stroke and patients early-term prognosis. Methods A total of 225 patients with acute ischemic stroke were selected as case group and 212 healthy physical examination patients in our hospital physical examination centre in same time as control group. The case group were classified according to TOAST criteria and analyzed the correlations between different serum uric acid level and TOAST subtypes. The case group were classified by serum uric acid level into normal uric acid group and high uric acid group,and evaluated by NIHSS and Barthe Index. Results The serum uric acid level in the case group were higher than the normal group（ P 〈 0. 01）. Meanwhile,the serum uric acid level were significantly higher in patients with subtype LAA and SAO comparing with others subtypes（ P〈0. 01）. The remarkable variations were revealed in NIHSS and Barthe Index between the high uric acid group and normal uric acid group（ P 〈 0. 05）. Conclusion The level of serum uric acid correlates with TOAST subtypes and early-term prognosis,the level more high,the prognosis more bad.