老年缺血性脑卒中患者颈动脉硬化及颅内动脉狭窄与血清尿酸水平的相关性研究

Correlation of serum uric acid level with carotid atherosclerosis and intracranial stenosis in elderly patients with cerebral ischemic stroke

目的 探讨老年缺血性脑卒中患者颈动脉硬化及颅内动脉狭窄与血清尿酸水平的关系. 方法 选取186例老年缺血性脑卒中患者进行颈动脉超声及经颅多普勒检查,分别判断颈动脉内中膜厚度（IMT）及颅内动脉狭窄情况.根据颈动脉IMT分为内膜正常组、内膜增厚组、斑块组及狭窄组;根据颅内动脉狭窄分为狭窄组和无狭窄组.检测患者血清尿酸（UA）、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）的浓度,采用Logistic回归分析颈动脉硬化、颅内动脉狭窄的相关因素. 结果 斑块组及狭窄组高血压者比例、冠心病者比例、TC水平较内膜正常组及内膜增厚组高,差异有统计学意义（均P＜0.05）;随着IMT增加,血尿酸水平依次增加（F=11.386,P=0.000）;多分类Logistic回归分析显示,血尿酸水平高是颈动脉硬化的独立危险因素（OR=3.486,P=0.013）.186例缺血性脑卒中患者中43例（23.1％）发生颅内动脉狭窄,狭窄组血尿酸水平较无狭窄组明显增高[（517.6±63.2） μmol/L比（401.3±55.4）μmol/L,t=9.372,P=0.013];二分类Logistic回归分析显示,血尿酸水平高是颅内动脉狭窄的独立危险因素（OR=1.914,P=0.022）. 结论 老年缺血性脑卒中患者颈动脉硬化程度及颅内动脉狭窄与高尿酸血症有密切的关系,提示血尿酸水平可反映颈动脉硬化程度.

Objective To investigate the relationship of serum uric acid level with carotid atherosclerosis and intracranial stenosis in patients with cerebral ischemic stroke.Methods 186 patients checked by Color Doppler Flow Imaging （CDFI） and Transcranial Doppler （TCD） were enrolled.According to the degree of carotid intima-media thickness （IMT）, patients were divided into normal group, and intima thicken group, the plaque shaping group and the vascular stenosis group.According to the degree of intracranial stenosis, patients were divided into stenosis group and nonstenosis group.The serum levels of uric acid （UA）, triglycerides （TG）, total cholesterol （TC）, highdensity lipoprotein cholesterol （HDL-C）, low density lipoprotein cholesterol （LDL-C） were detected.The relative factors for carotid atherosclerosis and intracranial stenosis were analyzed by multiple logistic regression analysis.Results Compared with normal group and intima thicken group, the percentage of patients with hypertension, coronary heart disease and serum TC level were increased in plaque shaping group and vascular stenosis group （P〈0.05 for all）.With the increase of carotid IMT, serum UA level was also gradually increased （F=11.386, P =0.000）.Logistic regression analysis showed that serum UA level was the independent risk factor for carotid atherosclerosis （OR=3.486, P=0.013）.Among 186 patients, 43 cases （23.1%） had intracranial vascular stenosis.The UA level was higher in stenosis group than in non stenosis group （t=9.372, P=0.013）.Logistic regression analysis showed that serum UA level were the independent risk factors for intracranial arterial stenosis （OR =1.914, P=0.022）.Conclusions The occurrence of carotid atherosclerosis and intracranial stenosis are closely related with hyperuricemia in patients with cerebral ischemic stroke, which indicates serum uric acid level may reflect the degree of carotid artery atherosclerosis.