血尿酸水平对急性脑梗死合并高尿酸血症患者预后的影响分析

Effect analysis of serum uric acid level on prognosis of acute cerebral infarction with hyperuricemia

目的分析血尿酸水平对急性脑梗死合并高尿酸血症患者预后的影响。方法选取180例急性脑梗死合并高尿酸血症患者作为高尿酸血症组,其中88例未接受降尿酸治疗的患者作为未接受降尿酸治疗组,92例接受降尿酸治疗的患者作为接受降尿酸治疗组;另选择178例急性脑梗死无高尿酸血症患者作为尿酸正常组。所有患者均予以急性脑梗死常规治疗,接受降尿酸治疗组患者加用别嘌呤醇治疗。比较尿酸正常组与高尿酸血症组血尿酸水平,未接受降尿酸治疗组和接受降尿酸治疗组不同时间点血尿酸水平,各组不同时间点美国国立卫生研究院卒中量表(NIHSS)评分和治疗4周预后效果。结果高尿酸血症组患者的血尿酸为(510.01±55.77)μmol/L,高于尿酸正常组的(375.70±54.70)μmol/L,差异有统计学意义(P<0.05)。接受降尿酸治疗组和未接受降尿酸治疗组入院时血尿酸水平比较差异无统计学意义(P>0.05);接受降尿酸治疗组治疗2、4周的血尿酸水平均低于本组入院时和未接受降尿酸治疗组同期,接受降尿酸治疗组治疗4周的血尿酸水平低于本组治疗2周,差异有统计学意义(P<0.05)。未接受降尿酸治疗组与接受降尿酸治疗组患者入院时NIHSS评分比较差异无统计学意义(P>0.05);未接受降尿酸治疗组治疗2、4周的NIHSS评分均高于接受降尿酸治疗组和尿酸正常组,接受降尿酸治疗组治疗2、4周的NIHSS评分均高于尿酸正常组,差异均有统计学意义(P<0.05)。治疗4周,尿酸正常组患者的总有效率87.08%显著高于接受降尿酸治疗组的77.17%和未接受降尿酸治疗组的63.64%,接受降尿酸治疗组患者的总有效率显著高于未接受降尿酸治疗组,差异均有统计学意义(P<0.05)。结论高尿酸血症影响了急性脑梗死患者的预后,降尿酸治疗可提高患者的疗效。

Objective To analyze the effect of serum uric acid level on prognosis of acute cerebral infarction with hyperuricemia.Methods There were 180 patients with acute cerebral infarction complicated with hyperuricemia selected as hyperuricemia group,of which 88 patients without uric acid-lowering treatment were selected as non-uric acid-lowering treatment group,92 patients with uric acid-lowering treatment were selected as uric acid-lowering treatment group,and another 178 acute cerebral infarction patients without hyperuricemia were selected as normal uric acid group.All patients received conventional treatment for acute cerebral infarction,and allopurinol was added to the hypouricemia treatment group.Comparison was made on levels of serum uric acid between normal uric acid group and hyperuricemia group,non-uric acid-lowering treatment group and uric acid-lowering treatment group at different time points,and National Institutes of Health stroke scale(NIHSS)score at different time points and 4-week prognosis in each group.Results The serum uric acid of hyperuricemia group was(510.01±55.77)μmol/L,which was significantly higher than(375.70±54.70)μmol/L of normal uric acid group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in serum uric acid at admission between non-uric acid-lowering treatment group and uric acid-lowering treatment group(P>0.05).After 2 and 4 weeks of treatment,the serum uric acid of uric acid-lowering treatment group was lower than that at admission and the same period of the non-uric acid-lowering treatment group.After 4 weeks of treatment,the serum uric acid of uric acid-lowering treatment group was lower than that after 2 weeks of treatment,and the difference was statistically significant(P<0.05).There was no statistically significant difference in NIHSS score at admission between non-uric acid-lowering treatment group and uric acid-lowering treatment group(P>0.05).After 2 and 4 weeks of treatment,the NIHSS score of non-uric acid-lowering treatment group was higher than that of uric acid-lowering treatment group and normal uric acid group,and uric acid-lowering treatment group was higher than that of normal uric acid group.All the difference was statistically significant(P<0.05).After 4 weeks of treatment,the total effective rate 87.08%of normal uric acid group was significantly higher than 77.17%of uric acid-lowering treatment group and 63.64%of non-uric acid-lowering treatment group,and the difference was statistically significant(P<0.05).Conclusion Hyperuricemia affects the prognosis of patients with acute cerebral infarction,uric acid-lowering therapy can improve the treatment efficiency of patients.