脑卒中患者血尿酸水平及其与预后关系的分析

Relationship between serum uric acid level and prognosis of stroke

【目的】探讨急性脑卒中患者血清尿酸水平与脑卒中的发生及其与预后的相关性。【方法】选取2015年1月至2017年1月在长海社区卫生服务中心住院首次确诊为急性脑卒中的患者287例为病例组,其中脑梗死患者160例(脑梗死组),脑出血患者117例(脑出血组),测定患者血清中血脂、尿酸等生化指标的浓度,与同期入院健康体检人群100例(对照组)进行比较,分析尿酸水平与.脑卒中发生的关系,对脑梗死患者尿酸水平与氧化性低密度脂蛋白进行相关性分析,并对上述所有卒中患者进行出院改良Rankin量表评分,研究血清尿酸浓度与卒中预后的相关性。【结果】脑梗死患者血清中尿酸浓度显著低于对照组;其中男性脑梗死患者尿酸水平低于对照组,差异具有统计学意义(P<0.05),女性患者与对照组相比无显著差别(P>0.05);高年龄组脑梗死患者尿酸水平低于对照组(P<0.05),低年龄组尿酸水平与对照组组较,差异无统计学意义(P>0.05);脑出血组患者的尿酸浓度低于健康对照组,无论性别和年龄均有差异(P<0.01);对所有卒中患者进行出院评分,发现脑梗死患者尿酸水平高,预后好;尿酸水平低,则预后差(P<0.01)。脑出血患者尿酸水平也有这一趋势(P=0.05)。【结论】脑梗死和脑出血患者血清尿酸水平降低,尿酸水平可能是脑卒中患者一种有益的预后指标。

[Objective]To investigate the correlation between serum uric acid levels and acute stroke,its incidence and prognosis.[Methods]From January 2015 to January 2017 in Changhai Community Health Service Centers,a series of 287 hospitalized patients first diagnosed with acute stroke were as the case group,of whom 160 were with cerebral infarction(CI group),and 117 with intracerebral hemorrhage(brain hemorrhage). Their concentration of serum lipids,uric acid and other biochemical indicators were measured in comparison with those of 100 healthy people(control group),and the relationship was analyzed between uric acid levels and the occurrence of stroke,and between uric acid levels and the oxidized low density lipoprotein in cerebral infarction. All above stroke patients were scored with discharge modified Rankin scale,for investigation of the relationship between serum uric acid concentration and stroke prognosis.[Results]Serum uric acid concentration in infarction was significantly lower than that in the control group;uric acid levels in male patients with cerebral infarction was lower than those in the control group,the difference being statistically significant(P<0.05). But in female patients,the difference in uric acid was not of statistical significance as compared with that of the control group. Uric acid level in high age patients with cerebral infarction was lower than the control group,while uric acid level in the low age group was slightly lower than that in the control group,but the difference was not statistically significant;uric acid concentrations in patients with cerebral hemorrhage was lower than those in the healthy control group,the difference being existant in both sex and age(P<0.01);discharge score for all stroke patients showed that the higher the levels of uric acid was found in patients with cerebral infarction,the better was the prognosis,and the worse was the prognosis if patients’ uric acid levels were lower. Uric acid levels(P<0.01)in patients with intracerebral hemorrhage showed this trend too.(P=0.05).[Conclusion]Serum uric acid levels are decreased in cerebral infarction and cerebral hemorrhage and may be a useful prognostic indicator for stroke patients.