别嘌醇治疗对急性脑梗死合并高尿酸血症病人预后的影响

Effect of Allopurinol on the Prognosis in Patients with Acute Ischemic Stroke Complicated with Hyperuricemia

目的观察别嘌醇治疗对急性脑梗死合并高尿酸血症病人预后的影响。方法连续收集发病7 d内住院的急性脑梗死合并高尿酸血症病人430例,随机分成两组。对照组给予常规的脑梗死二级预防药物治疗,治疗组在此基础上加用别嘌醇治疗,每两周测血清尿酸水平,调整别嘌醇剂量至尿酸水平降到357μmol/L(6 mg/d L)以下,分别于治疗30 d、90 d对两组病人进行日常生活能力评定量表(BI指数)、改良Rankin量表(mRS评分)评估。结果与对照组比较,治疗组在30 d、90 d血尿酸值较治疗前水平有明显降低,BI、MRS等神经功能评分与对照组比较差异有统计学意义(P<0.05)。结论高尿酸可能加重脑梗死病人的病情并影响预后,应尽早治疗;别嘌醇可以降低血清尿酸水平,对急性脑梗死病人预后的影响是安全有益的。

Objective To investigate the effect of al opurinol on the prognosis in patients with acute ischemic stroke complicated with hyperuricemia.Methods Four hundreds and thirty patients with acute ischemic stroke complicated with hyperuricemia were randomly divided into two groups:control group treated with routine treatment,and treatment group treated with routine treatment and al opuri-nol.The serum uric acid level was observed every two week and adjusted the dose of al opurinol until the serum uric acid level de-clined to 357 umol/L or lower level in treatment group.The scores of Barthel index (BI),modified Rankin Scale (mRS)were evalua-ted after 30 days and 90 days. Results Compared with control group,the serum uric acid level was significantly decreased af in treatment group ter 30 days and 90 days.The scores of BI and mRS in treatment group were better than that in control group (P<0. 05).Conclussion Al opurinol can decrease serum uric acid level,which wil be beneficial to the prognosis in patients with acute is-chemic stroke.