短暂性脑缺血发作和轻型卒中患者认知功能障碍与血清尿酸水平的相关性研究

Correlation between Cognitive Impairment and Serum Uric Acid Level in Patients with Transient Ischemic Attack or Minor Stroke

目的探讨血清尿酸水平与TIA/轻型卒中患者认知障碍的关系。方法收集2015年6月-2016年6月在上海长海医院住院治疗的78例TIA/轻型卒中患者的临床资料、影像学资料。按照患者的蒙特利尔认知评估量表评分,分为认知功能障碍组和认知功能正常组。比较两组患者血清尿酸水平的差异,并采用多因素Logistic回归分析尿酸水平与认知功能障碍的关系。结果 78例TIA/轻型卒中患者中,认知功能障碍组34例,认知功能正常组44例。认知功能障碍组高血压(70.6%vs45.5%,P=0.026)及糖尿病(52.9%vs29.5%,P=0.036)患病率均高于认知功能正常组,差异有统计学意义。认知功能障碍组血清尿酸[(0.31±0.07)mmol/L]低于认知功能正常组[(0.36±0.09)mmol/L],差异有统计学意义(P=0.003)。尿酸水平是认知功能障碍的独立保护因素(OR 0.990,95%CI 0.984～0.997,P=0.008)。结论对于TIA/轻型卒中患者,认知功能障碍患者较认知功能正常者糖尿病、高血压患病率高,尿酸水平低。血清尿酸水平是认知功能障碍的独立保护因素。

Objective To investigate the relationship between serum uric acid level and cognitive impairment in patients with TIA/minor stroke.Methods The clinical and imaging data of 78 patients with TIA/minor stroke who were hospitalized in Shanghai Changhai hospital from June 2015 to June 2016.Patients were divided into cognitive impairment and no cognitive impairment group by using the Montreal cognitive assessment scale.The difference of serum uric acid levels between the two groups was tested by t test,and the relationship between serum uric acid level and cognitive impairment was analyzed by multivariate logistic regression analysis.Results A total of 78 patients with TIA/minor Stroke were enrolled,with 34 in cognitive impairment group and 44 in no cognitive impairment group.The prevalence of hypertension(70.6%vs 45.5%,P=0.026)and diabetes(52.9%vs 29.5%,P=0.036)in cognitive impairment group were higher than that in no cognitive impairment group.The serum uric acid level in cognitive impairment group[(0.31±0.07)mmol/L]was lower than that in no cognitive impairment group[(0.36±0.09)mmol/L],which was statistically significant(P=0.003).Serum uric acid level was an independent protective factor of cognitive impairment(OR 0.990,95%CI 0.984-0.997,P=0.008).Conclusions Compared with patients with no cognitive impairment,the patients with cognitive impairment had higher prevalence of diabetes and hypertension and lower serum uric acid level.Serum uric acid level was an independent protective factor of cognitive impairment.