血清尿酸水平与缺血性脑卒中再发的相关性研究
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摘要
目的:探讨血清尿酸水平与缺血性脑卒中再发的关系。方法:选择首次发生缺血性脑卒中的患者1 070例为研究对象,随访2年内患者再发脑卒中的情况,按照是否再发分为再发组和无再发组,比较两组资料。结果:835例患者纳入随访系统,其中无再发组728例,再发组107例(再发率12.8%);研究发现再发组患者平均年龄(69.3±9.3)岁,高于无再发组(64.6±8.6)岁(P<0.05);再发组初次检测尿酸、肌酐、总胆固醇及甘油三酯各为(356.3±106.6)μmol/L、(80.6±9.5)μmol/L、(5.1±2.6)μmol/L、(1.6±0.3)μmol/L,与无再发组的(340.2±91.0)μmol/L、(82.2±13.3)μmol/L、(4.6±3.4)μmol/L、(1.6±0.4)μmol/L比较差异均无统计学意义(P>0.05);2年后随访再发组尿酸为(398.5±111.2)μmol/L,高于无再发组(315.5±88.8)μmol/L(P<0.05)。多因素Logistic回归分析显示年龄(OR=4.540,95%CI 1.618～9.213,P=0.002)及尿酸水平(OR=2.875,95%CI1.275～6.305,P=0.012)是缺血性脑卒中再发的独立危险因素。结论:年龄及尿酸是缺血性脑卒中再发的独立危险因素,血清尿酸长期处于高水平可能增加再发风险。
Objective: To investigate the correlation between serum uric acid level and recurrence of ischemic stroke. Methods: 1 070 cases in the first ischemic stroke were served as research subjects. The patients were followed up for 2 years. The pationts were divided into reissue group and no retransmission group according to whether it was reissued. The data were compared between the two groups. Results: A total of 835 patients were enrolled in the follow-up system, including 728 in the no-recurrence group and 107 in the re-exposure group(recurrence rate 12.8%). The mean age of the recurrent group(69.3± 9.3)years was higher than that in the no-recurrence group(64.6±8.6) years(P<0.05), uric acid, creatinine, total cholesterol and triglyceride(356.3±106.6)μmol/L,(80.6±9.5)μmol/L,(5.1±2.6)μmol/L,(1.6±0.3)μmol/L were detected for the first time in the recurrent group, and(340.2±91.0)μmol/L,(82.2±13.3)μmol/L,(4.6±3.4)μmol/L,(1.6±0.4)μmol/L in the no-recurrence. There was no statistical significance between the two groups(P>0.05). The uric acid level in the recurrence group(398.5± 111.2) μmol/L after 2 years of follow-up was significantly higher than in the no-recurrence group(315.5±88.8)μmol/L(P<0.05). Multivariate Logistic regression analysis showed that age(OR= 4.540, 95% CI 1.618～ 9.213, P=0.002)and uric acid level(OR=2.875, 95% CI 1.275～ 6.305, P= 0.012) were independent risk factors for recurrent ischemic stroke. Conclusion: Age and uric acid are independent risk factors for recurrent ischemic stroke. Long-term high serum uric acid may increase recurrence rate.
Objective: To investigate the correlation between serum uric acid level and recurrence of ischemic stroke. Methods: 1 070 cases in the first ischemic stroke were served as research subjects. The patients were followed up for 2 years. The pationts were divided into reissue group and no retransmission group according to whether it was reissued. The data were compared between the two groups. Results: A total of 835 patients were enrolled in the follow-up system, including 728 in the no-recurrence group and 107 in the re-exposure group(recurrence rate 12.8%). The mean age of the recurrent group(69.3± 9.3)years was higher than that in the no-recurrence group(64.6±8.6) years(P<0.05), uric acid, creatinine, total cholesterol and triglyceride(356.3±106.6)μmol/L,(80.6±9.5)μmol/L,(5.1±2.6)μmol/L,(1.6±0.3)μmol/L were detected for the first time in the recurrent group, and(340.2±91.0)μmol/L,(82.2±13.3)μmol/L,(4.6±3.4)μmol/L,(1.6±0.4)μmol/L in the no-recurrence. There was no statistical significance between the two groups(P>0.05). The uric acid level in the recurrence group(398.5± 111.2) μmol/L after 2 years of follow-up was significantly higher than in the no-recurrence group(315.5±88.8)μmol/L(P<0.05). Multivariate Logistic regression analysis showed that age(OR= 4.540, 95% CI 1.618～ 9.213, P=0.002)and uric acid level(OR=2.875, 95% CI 1.275～ 6.305, P= 0.012) were independent risk factors for recurrent ischemic stroke. Conclusion: Age and uric acid are independent risk factors for recurrent ischemic stroke. Long-term high serum uric acid may increase recurrence rate.
引文
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[3] 孙东霞,丁岩.尿酸与脑血管病及其高危因素相关性的研究进展[J].北京医学,2018,40(5):457-459.
[4] 杜朝品.高尿酸血症与缺血性脑卒中急性期和远期预后的相关性研究[J].贵州医药,2018,42(12):1488-1489.
[5] 王莉,王孟坤,温慧军,等.急性缺血性脑卒中患者颈动脉狭窄与肌红蛋白、尿酸的相关性分析[J].中风与神经疾病杂志,2018,35(10):908-910.
[6] 范琳,黄晶,吴正刚,等.尿酸与缺血性脑卒中rt-PA静脉溶栓预后:前瞻性研究[J].中风与神经疾病杂志,2018,35(1):48-51.
[7] 勾威,申丽盈,王钒,等.别嘌呤醇治疗动脉粥样硬化伴高尿酸血症对血脂代谢及肝肾功能的影响[J].贵州医药,2018,42(6):678-679.
[8] 尹士男,江华.代谢综合征的诊治进展[J].中华老年心脑血管病杂志,2018,20(11):1121-1123.
[9] 陈传良.动脉粥样硬化患者检测Lp(a)、hs-CRP、D-Dimer的临床意义[J].中国实验诊断学,2018,22(7):1168-1169.
[10] 夏蓉晖,聂颖,赵绵松,等.某高校退休职工血尿酸水平与颈动脉粥样硬化的关系[J].山西医科大学学报,2018,49(12):1471-1475.
[11] 张萃萍,欧阳晓春,余小骊,等.中老年人群肾小球滤过率与急性缺血性脑卒中的关系[J].上海交通大学学报(医学版),2019,39(1):65-68.
[12] 梁志刚,孙旭文,杨绍婉,等.伴有颈动脉斑块的急性缺血性卒中患者急性期血清学相关指标水平的研究[J].临床神经病学杂志,2018,31(6):425-428.
[13] 陈晓莉.老年缺血性脑卒中危险因素分析[J].中西医结合心脑血管病杂志,2016,14(19):2308-2310.
[14] 余洋,杨熹.代谢综合征及相关因子对缺血性脑卒中再发的影响研究[J].重庆医学,2017,46(11):1484-1486.