尿酸与颈动脉粥样硬化性狭窄的相关性研究

The Association between Serum Uric Acid and Atherosclerotic Carotid Artery Stenosis

目的:为探讨血清尿酸与颈动脉粥样硬化性狭窄的相关性。方法:回顾性收集2021年1月至2021年12月在临沂市人民医院神经科及健康管理中心行颈动脉血管超声检查的903例(狭窄238例,非狭窄665例)卒中及非卒中患者作为研究对象。彩色多普勒血流超声(CDFI)用于评估颈动脉粥样硬化狭窄情况,我们将颈动脉狭窄程度 ≥ 50%或闭塞定义为颈动脉粥样硬化性狭窄。多因素Logistic回归分析模型用于分析尿酸与颈动脉粥样硬化性狭窄的相关性。结果:共纳入903例患者,急性缺血性脑卒中584例(颈动脉狭窄168例)和非急性缺血性卒中患者319例(颈动脉狭窄70例),总体人群中,中位血清尿酸水平293 umol/dL (四分位间距251~357 umol/dL)。在缺血性脑卒中患者中,颈动脉粥样硬化性狭窄组的尿酸水平高于非狭窄组(P = 0.002),同样,在非卒中组,颈动脉粥样硬化性狭窄组的尿酸水平明显高于非狭窄组(P = 0.003)。多变量Logistic回归分析显示,年龄、性别、高密度脂蛋白、糖尿病、高血压、吸烟是颈动脉粥样硬化狭窄的独立危险因素,尿酸(OR = 1.003, 95% CI = 1.002~1.005, P < 0.001)是颈动脉粥样硬化性狭窄独立危险因素。结论:血清尿酸水平高与颈动脉粥样硬化性狭窄风险高相关。

Objective: To investigate the association between serum uric acid and atherosclerotic carotid artery stenosis. Methods: A total of 903 stroke and non-stroke patients (238 with stenosis and 665 without stenosis) who underwent carotid artery ultrasound examination in the Department of Neurology and Health Management Center of Linyi People’s Hospital from January 2021 to December 2021 were selected as the research subjects. Ultrasound color Doppler flow imaging was used to evaluate carotid atherosclerotic stenosis, and carotid artery stenosis ≥ 50% or occlusion is diagnosed as stenosis. Multivariate logistic regression was used to analyze the association between uric acid and carotid atherosclerotic stenosis. Results: Totally 903 patients were included, 584 cases of acute ischemic stroke (168 cases of carotid artery stenosis) and 319 cases of non acute ischemic stroke (70 cases of carotid artery stenosis), and the median serum uric acid level was 293 umol/dL (interquartile range: 251~357 umol/dL). In ischemic stroke patients, the level of uric acid in carotid atherosclerotic stenosis group was higher than that in non stenosis group (P = 0.002). Similarly, in non stroke group, the level of uric acid in carotid atherosclerotic stenosis group was significantly higher than that in non stenosis group (P = 0.003). Multivariate logistic regression analysis showed that age, sex, high-density lipoprotein, diabetes, hypertension and smoking were independent risk factors for carotid atherosclerosis stenosis, and uric acid (OR = 1.003, 95% CI = 1.002~1.005, P < 0.001) was an independent risk factor for carotid atherosclerotic stenosis. Conclusion: High serum uric acid level is associated with high risk of carotid atherosclerotic stenosis.