高尿酸血症对急性脑梗死病人静脉溶栓结局的影响

Influence of hyperuricemia on the outcome of the patients with acute cerebral infarction receiving intravenous thrombolytic therapy

目的探讨高尿酸血症对急性脑梗死病人静脉溶栓治疗康复结局的影响。方法分析2015年9月至2018年9月于我院治疗的89例老年脑梗死病人,根据病人尿酸水平分为高尿酸血症组与正常尿酸组。在入院时及溶栓后24 h采用美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评估病人脑梗死严重程度及恢复情况,在溶栓后第7天和第90天应用Barthel指数(Barthel Index,BI)和改良的Rankin量表(modified Rankin Scales,mRS)评估2组病人日常生活功能以及神经功能恢复情况。结果2组病人入院时NIHSS评分差异无统计学意义(P>0.05);溶栓后24 h,2组病人NIHSS评分较入院时明显降降低(P<0.01),且溶栓后正常尿酸组较高尿酸血症组低(P<0.01)。2组病人入院时Barthel指数评分及mRS评分差异均无统计学意义(P>0.05);溶栓后第7天和第90天,2组Barthel指数均较溶栓前明显升高(P<0.01),mRS评分较溶栓前明显降低(P<0.01),且2组间比较差异有统计学意义(P<0.05或P<0.01)。结论高尿酸血症对老年脑梗死病人的康复结局产生不利的影响,可能是脑梗死病人预后较差的独立危险因素。

Objective To investigate the influence of hyperuricemia in the treatment of patients with acute cerebral infarction receiving intravenous thrombolytic therapy.Methods A total of 89 elderly patients admitted to our hospital from September 2015 to September 2018 were analyzed.Patients were divided into hyperuricemia group and normal uric acid group according to the level of uric acid.The National Institutes of Health Stroke Scale(NIHSS)was used to assess the severity of cerebral infarction at admission and 24 h after thrombolysis,the Barthel Index(BI)and modified Rankin Scales(mRS)were used to evaluate the physical functional and neural function of the two groups 7 and 90 days after thrombolysis.Results After treatment,the NIHSS scores of the two groups were significantly lower than those at admission(P<0.01),and the NIHSS score of the normal uric acid group was significantly lower than that of the hyperuricemia group(P<0.01).The BI scores of the two groups were significantly higher than those before thrombolysis at 7 and 90 days after thrombolysis(P<0.01),and the mRS scores was significantly lower than those before thrombolysis(P<0.01).There were statistically differences between the two groups(P<0.05 or P<0.01).Conclusions Hyperuricemia can adversely affect the outcome of elderly patients with cerebral infarction.