尿酸与急性缺血性脑卒中患者病情严重程度和预后的相关性研究

Association of serum uric acid level with severity and outcome of acute ischemic stroke

目的探讨血尿酸水平与急性缺血性脑卒中患者入院时病情严重程度和短期预后的关系。方法选择急性缺血性脑卒中患者496例,根据血尿酸水平分为高尿酸组119例,正常尿酸组377例。收集人口统计学信息、生活方式、疾病史、入院时尿酸水平等,评估患者入院时及出院时临床神经功能。以尿酸274、338和411mmol/L为截取点比较不同血尿酸水平患者短期预后的差异。结果高尿酸组尿酸、神经功能好转率明显高于正常尿酸组[(438.30±80.24)mmol/L vs(274.50±84.82)mmol/L,P=0.000;(62.00±22.00)%vs(57.00±15.00)%,P=0.005],出院时美国国立卫生研究院卒中量表评分明显低于正常尿酸组[(4.80±2.21)分vs(5.60±3.58)分,P=0.022]。与尿酸≥412μmol/L患者比较,尿酸≤274μmol/L患者预后不良明显升高(45.2%vs 29.6%,P<0.05)。结论血尿酸水平与急性缺血性脑卒中患者入院时病情严重程度无相关性,血尿酸水平升高有助于缺血性脑卒中早期神经功能恢复,提示高尿酸水平对急性缺血性脑卒中具有一定的保护作用。

Objective To study the association of serum uric acid （UA） level with the severity and outcome of acute ischemic stroke （AIS）. Methods Four hundred and ninety-six acute AIS pa- tients were divided into high serum UA level group （n= 119） and normal serum UA level group （n=377）. Their demographic data,life style,history of disease,serum UA level were recorded on admission. Their neurological function was assessed at the time of admission and discharge. Their short-terra outcomes were compared with the different serum UA levels （274 retool/L,338 mmol/L. and 411 mmol/L） as the interception points. Results The improved serum UA level and neuro- logical function were significantly higher while the NIHSS score at discharge was significantly lower in high serum UA level group than in normal serum UA level group （438. 30 ±80. 24 mmol/L vs 274. 50±84. 82 mmol/L,P=0. 000;62. 00%±22. 00% vs 57. %±15.00%,P=0. 005;4. 80±2. 21 vs 5.60±3.58,P=0. 022）. The poor outcome rate was significantly higher in patients with their serum UA level 4274 μmol/L than in those with their serum UA level ≥412 μmol/L （45.2%s 29.6% ,P〈0. 05）. Conclusion The serum UA level is not associated with the severity of AIS on admission. The elevated serum UA level contributes to the recovery of neuro- logical function in early AIS patients, suggesting that high serum UA level plays a certain role in protecting against AIS.