血尿酸对缺血性卒中患者发病影响的前瞻性研究

A prospectively study on the association between serum uric acid concentration and ischemia stroke

目的前瞻性的分析血尿酸对缺血性脑卒中患者发病的影响。方法以2010年在医院健康体检的4 380例对象作为观察队列,将不同性别的人群按首次健康体检的血尿酸水平分为5个组,随访4年,用COX比例风险模型分析血尿酸对缺血性脑卒中患者发病的影响。结果 (1)血尿酸高于正常值组和低于正常值组年龄比正常组大,体重指数和吸烟、饮酒、口服降压药、高血压病史、高脂血症病史、糖尿病史所占比例及缺血性脑卒中发病率均比正常组高;正常1组、正常2组、正常3组患者的体重指数和年龄依次升高,吸烟、饮酒、口服降压药、高血压病史、高脂血症病史、糖尿病史所占比例依次升高;(2)按血尿酸水平分为不同组后发病率差异有统计学意义(男:χ~2=18.97,P<0.05;女:χ~2=16.23,P<0.05);(3)多因素COX风险比例回归模型以血尿酸正常1组为参照,女性:校正其他相关因素的影响,与血尿酸水平为100~170相比,血尿酸水平50~100,170~240,240~300,300~500μmol·L^(-1)发生缺血性脑卒中的危险性分别1.981,1.051,1.683,2.012。男性:校正其他相关因素的影响,与血尿酸水平为100~170μmol·L^(-1)相比,血尿酸水平60~150、230~310、310~380、380~500μmol·L^(-1)发生缺血性脑卒中的危险性分别为2.216,1.693,2.331,5.672。结论低血尿酸水平和高血尿酸水平发生缺血性脑卒中的危险性均较高,维持好血尿酸水平可显著降低缺血性脑卒中的发生率。

Objective To prospectively investigate the association between serum uric acid concentration and ischemia stroke. Methods In this prospective cohort study,a total of 4380 participants were included and were categorized into 5 groups according to serum uric acid concentration and gender which were collected during 2013 to 2014 by health examinations. The study was followed up for 4years. Cox regression model was used to analysis the association between serum uric acid concentration and ischemia stroke. Results1） Higher and lower concentrations of serum uric acid were associated with older age,body mass index（ BMI）,smoking,alcohol drinking,antihypertensive medication use,history of hypertension,history of diabetes,history of hyperlipidemia and ischemic stroke incidence. In normal group,increased age and body mass index,smoking,alcohol drinking,antihypertensive medication use,history of hypertension,history of diabetes,history of hyperlipidemia in group 1,group 2 and group 3.（ 2） The incidence of ischemia stroke were statistically significant in men（ χ^2= 18. 97,P〈0. 05） and in women（ χ^2= 16. 23,P〈0. 05）.（ 3） After adjusting for potential confounders,the OR of ischemia stroke across serum uric acid quintiles were 1. 981,1. 051,1. 00,1. 683,2. 012 in women and 2.216,1. 693,1. 00,2. 331,5. 672 in men. Conclusion A higher risk of developing ischemia stroke in association with low or high serum uric acid quintiles. Keeping a balanced serum uric acid will decreased the ischemia stroke occurrence rate.