血清尿酸水平与急性脑卒中短期临床结局的关系

张晓龙; 张金涛; 彭颖; 许锬; 张永红

Abstract

张晓龙,张金涛,彭颖,许锬,张永红.血清尿酸水平与急性脑卒中短期临床结局的关系[J].Chinese journal of Epidemiology,2012,33(5):529-533

血清尿酸水平与急性脑卒中短期临床结局的关系

Association between serum uric acid and short-term clinical outcome among padents with acute stroke

Received:November 15, 2011

DOI：

KeyWord: 脑梗死脑出血尿酸预后

English Key Word: Brain ischemia Intracranial hemorrhages Utic acid Prognosis

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Author Name	Affiliation	E-mail
Zhang Xiaolong	Department of Epidemidogy and Biostatistics, School of Public Health, Soochow University, Suzhou 215123, China
Zhang Jintao	The 88th Hospital of Jinan Military Command
Peng Ying	Department of Epidemidogy and Biostatistics, School of Public Health, Soochow University, Suzhou 215123, China Zhejiang Provinciaf Cemer for Disease Corarof and Prevention
Xu Yan	Department of Epidemidogy and Biostatistics, School of Public Health, Soochow University, Suzhou 215123, China
Zhang Yonghong	Department of Epidemidogy and Biostatistics, School of Public Health, Soochow University, Suzhou 215123, China	ybzhang@suda．edu．cn

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Abstract:

目的探讨血清尿酸水平与急性脑卒中短期临床结局的关系。方法以3231例住院急性脑卒中患者为研究对象，收集人口统计学、生活方式、疾病史、人院尿酸及出院结局等临床特征资料。将出院时神经功能评分≥10或住院期间死亡定义为不良结局。结果人院时尿酸水平升高与急性缺血性脑卒中患者短期不良结局的危险性下降有关。经多因素调整后，尿酸水平每升高1个单位，发生不良结局的OR=O．856(95％CI：O．795～0．898)。按尿酸水平的5分位分析，经多因素调整后，与尿酸<197μmol／L者相比，尿酸水平在197~241、242~285、286～346和≥347μmol/L的缺血性脑卒中患者发生不良结局的OR值(95％CI)分别为O．552(0．354。O．861)、0．417(0．263～0．661)、0．390(0．241一O．630)和O．352(0．213～O．581)，呈现随尿酸水平升高，不良结局危险性而下降的趋势。出血性脑卒中患者尿酸水平每升高1个单位，发生不良结局的0R值无统计学意义。按尿酸水平的5分位进行分析，经多因素调整后，与尿酸<150μmol／L者相比。尿酸水平在150～185、186—230、23l～297和一>298μmol／L的出血性脑卒中患者发生不良结局的OR值也无统计学意义。结论血清尿酸水平升高是急性缺血性脑卒中患者短期预后良好的独立预测因子。

English Abstract:

Objective To investigate the associaion between sgrum uric acid(SUA)and early clinical outcome among patients with acute stroke.Methods A total of 323 1 acute stroke patients were included in the present study.Data on demographic characteristics,life style risk factors,history of disease.admission SUA and clinical outeome at discharge were collected for all participants.Poor clinical outcome was defined as neurologic deficiency lNIHSS≥10)at discharge or death during hospitalization.ResultsIncreased SUA 1evel was associated with decreased risk of poor outcome among ischemic stroke patients.Afteradjustment for multivariate.the odds ratio(95％confidence imerval)of poor outcome for every increased unit was 0.856(0.795—0.898)among ischemic stroke patients.Logistic analysis was conducted according to quintile of SUA level,after adjustment for multi-variates,the odds ratio(95％confidence interval)ofpoor clinical outcome appeared to be associated with SUA of 197—24lμmol／L,242-285 μmol／L,286—346 μmol／L and≥347μmol／L,but were 0.552(0.354—0.861),0.417(0.263—0.66I),0.390(0.24l一0.630)and 0.352(O.213-0.581)respectivelyin those acutei schemics stroke patients.when compared to thosewith SUA<197μmol／L.Among acute hemorrhagic stroke patients.after adjustment for multivariate the odds ratio(95％confidence interval)ofpoor outcome for every increased unit was not significant among hemorrhagics stroke patients.According to the quintile of SUA level.when compared to those with SUA<150μmol／L,the odds ratio(95％confidence interval)of poor clinical outcomes associated with SUA of 150—185μmol／L 186—230 μmol／L,231-297 μmol／L and≥298 μmol／L were also not significant among those hemorrhagics stroke patients.Conclusion Elevated SUA seemed to be an independent predictor for short-term good clinica outcome among acute ischemic stroke patients.

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