血尿酸水平与急性缺血性脑卒中预后关系的meta分析

Relationship between serum uric acid level and prognosis of acute ischemic stroke:a meta-analysis

目的通过meta分析评价急性缺血性脑卒中后血清尿酸(serum uric acid,SUA)水平与预后之间的关联性。方法通过计算机检索Pubmed、Embase、Cochrane library数据库,收集2019年11月20日以前公开发表的有关SUA水平与急性缺血性脑卒中预后关系的研究文献,并查阅获得文献的参考文献,收集包括95%置信区间(95%CI)的每单位SUA水平急性缺血性脑卒中预后的比值比(OR),评价纳入研究的偏倚分析后,采用Stata 16.0进行meta分析,并用漏斗图检测文献的发表偏倚。结果共纳入14项研究,共15283例急性缺血性脑卒中患者。与低SUA水平相比,高SUA水平与急性缺血性脑卒中的良好预后相关(OR=1.18,95%CI,1.10-1.26,P=0.006)。敏感性分析进一步确定SUA水平对急性缺血性脑卒中的影响。预后好的患者SUA水平高于预后差的患者。在meta分析中未发现明显的发表偏倚。结论本meta分析支持SUA水平对急性缺血性脑卒中后神经功能有保护作用。

Objective To evaluate the relationship between serum uric acid(SUA)level and the prognosis of acute ischemic stroke.Methods Pubmed,Embase,Cochrane library databases were searched for the literatures about the relationship between SUA level and the prognosis of acute ischemic stroke from inception to November 20,2019.The reference literatures were also consulted.The odds ratio(OR)of the prognosis of acute ischemic stroke per unit of SUA level in 95%confidence interval(95%CI)was collected.After evaluating the bias analysis of included studies,a meta-analysis was performed by Stata 16.0 software.Results Fourteen studies involving 15283 patients with acute ischemic stroke were included.Compared with the low SUA level,the high SUA level was related to the good prognosis of acute ischemic stroke(OR=1.18,95%CI,1.10-1.26,P=0.006).Sensitivity analysis further identified the effects of SUA levels on the prognosis of acute ischemic stroke.Patients with good prognosis had a higher SUA level than those with poor prognosis.There was no obvious publication bias found in the meta-analysis.Conclusion This meta-analysis supports that SUA level has a protective effect on neurological prognosis after acute ischemic stroke.