血尿酸水平与高血压伴急性脑卒中临床相关性研究

Study on the clinical correlation between serum uric acid level and hypertension complicated with acute stroke

目的探讨血尿酸水平与高血压伴急性脑卒中患者的相关性,为急性脑卒中的防治寻求理论依据。方法本研究收集2016年11月~2017年8月石河子地区高血压伴脑梗死患者90例、高血压伴脑出血患者90例,高血压非脑血管病90例,选择同期体检健康者90例。分别于次日晨测定其血压、尿酸(UA)、空腹血糖(FBG)、血脂(TG、TC、HDL、LDL)水平,并进行比较。同时按照美国国立卫生研究院卒中量表(NIHSS)对所有患者神经功能缺失程度进行评分,按照评分分别将高血压伴脑梗死、高血压伴脑出血患者分成两个亚组,即0~4分为轻型组,5分及以上为中-重型组。结果 (1)四组比较,BMI、UA、FBG、TG、TC、LDL在高血压伴脑梗死组>高血压伴脑出血组>高血压非脑血管病组>健康对照组,差异有统计学意义(P<0.05)。HDL则相反,且有统计学意义(P<0.05)。高血压非脑血管病组及高血压伴脑梗死组、高血压伴脑出血组血压比较无明显差异(P>0.05)。(2)高血压伴脑梗死及高血压伴脑出血患者的血尿酸水平越高,神经系统缺损程度越重,差异有统计学意义(P<0.05)。结论血尿酸为急性脑卒中的危险因素,其与高血压患者伴急性脑卒中发生率及其病情严重程度均呈正相关。

Objective To explore the correlation between serum uric acid level and hypertension complicated with acute stroke, so as to seek theoretical basis for the prevention and treatment of acute stroke. Methods 90 patients with hypertension complicated with acute stroke, 90 patients with hypertension complicated with, intracerebral hemorrhage and 90 patients with hypertension not complicated with cerebrovascular disease in Shihezi area from November 2016 to August 2017 were collected in this study. 90 cases who received physical examination during the same period were selected. The levels of blood pressure, uric acid（UA）, fasting blood glucose（FBG）, blood lipids（TG, TC, HDL and LDL） were measured on the following morning. At the same time, according to the National Institutes of Health Stroke Scale （NIHSS）, the degree of neurological defects were scored for all patients. According to the scores, the patients with hypertension complicated with cerebral infarction, and the patients orrhage were divided into two subgroups, namely those with the with hypertension complicated with intracerebral hem- score of 0-4 were in mild type group, and those with the score of 5 and above were in the moderate-severe type group. Results （1）In the four groups, BMI, UA, FBG, TG, TC, LDL in hypertension complicated with cerebral infarction group〉 hypertension complicated with intracerebral hem- orrhage group〉 hypertension not complicated with cerebrovascular disease group〉 healthy control group, and the differ- ences were statistically significant（P〈0.05）. HDL was the on the contrary and the difference was statistically significant （P〈0.05）. The differences of blood pressure in hypertension not complicated with cerebrovascular disease and hyper- tension complicated with cerebral infarction, hypertension complicated with intracerebral hemorrhage were not statisti- cally significant（P〉0.05）. （2） The higher the level of serum uric acid in the patients with hypertension complicated with cerebral infarction and the patients with hypertension complicated with intracerebral hemorrhage, the more severe the degree of neurological defect, and the difference was statistically significant（P〈0.05）. Conclusion Serum uric acid is the risk factor for acute stroke. It is positively correlated with the incidence rate of acute stroke and the severity of the disease in the patients with hypertension.