高尿酸血症与缺血性脑卒中复发及动脉粥样硬化性颅内动脉狭窄的相关性

The Relationships Between Hyperuricemia,Recurrence of Cerebral Arterial Thrombosis and Atherosclerosis Intracranial Arterial Stenosis

目的探讨高尿酸血症与1年内缺血性脑卒中复发及动脉粥样硬化性颅内动脉狭窄之间的关系。方法选取本院神经内科2009年1月至2014年6月收治的280例非心源性脑梗死患者作为研究对象,其中伴高尿酸血症的脑卒中患者36例,不伴有高尿酸血症的脑卒中患者244例,应用颅内MRI血管成像技术检查颅内动脉粥样硬化狭窄情况。观察两组患者1年内脑卒中复发率。再对影响颅内动脉狭窄发生的因素进行单因素分析,后对单因素分析有显著差异的因素行多因素Logistic回归分析。结果伴高尿酸血症的脑卒中1年内脑卒中复发率明显高于不伴高尿酸血症的脑卒中患者,两者之间有统计学差异(P<0.05)。高尿酸血症(χ~2=4.309,P=0.044)、吸烟(χ~2=10.206,P=0.001)、糖尿病(χ~2=7.560,P=0.006)、高血压(χ~2=4.4477,P=0.034)与颅内动脉狭窄发生显著相关。颅内动脉狭窄关系多因素Logistic回归分析显示高尿酸血症(OR=0.353,95%CI=0.145~0.859,P=0.022)、吸烟(OR=0.468,95%CI=0.277~0.791,P=0.005)、糖尿病(OR=2.025,95%CI=1.186~3.458,P=0.01)是动脉粥样硬化性颅内动脉狭窄的独立危险因素。结论高尿酸血症患者缺血性脑卒中复发及动脉粥样硬化性颅内动脉狭窄的发生率明显增加。

Objective Discuss the relationship between the hyperuricemia and the one-year recurrence of cerebral arterial thrombosis,as well as the relation to the A、atherosclerosis intracranial arterial stenosis.Methods Pick up the 280 patients with non-cardiac cerebral infarction received from Jan 2009 to Jun 2014 in our hospital as the research targets,among whom 36 patients had the hyperuricemia. We use the intracranial MRI angiography to check the intracranial arterial stenosis caused by the atherosclerosis. After observing the recurrence rate of cerebral arterial thrombosis within these two group patients and then analyzing the sole factor causing the intracranial arterial stenosis,we will make the logistic regression analysis on the factors appearing the obvious differences. Results The recurrence rate of the patient with the hyperuricemia is obviously higher than that of the patients without the hyperuricemia. There are statistic difference( P < 0. 05) between them. The hyperuricemia( χ~2= 4. 309,P = 0. 044),smoking( χ~2= 10. 206,P = 0. 001),diabetes( χ~2= 7. 560,P = 0. 006)and hypertension( χ~2= 4. 4477,P = 0. 034) are of marked relation to the occurrence of the intracranial arterial stenosis. In the logistic regression analysis of multi-factors for intracranial arterial stenosis,the hyperuricemia( OR = 0. 353,95% CI = 0. 145 ~ 0. 859,P = 0. 022),smoking( OR = 0. 468,95% CI = 0. 277 ~ 0. 791,P =0. 005) and diabetes( OR = 2. 025,95% CI = 1. 186 ~ 3. 458,P = 0. 01) are the independent risking factors for the atherosclerosis intracranial arterial stenosis. Conclusion The patient with hyperuricemia has the higher risk in the recurrence of Cerebral Arterial Thrombosis and the higher risk to get atherosclerosis intracranial arterial stenosis.