血清尿酸水平与急性脑梗死患者神经功能缺损程度的相关性研究

目的探究血清尿酸(SUA)水平与急性脑梗死患者病情严重程度的相关性,为急性脑卒中的防治提供理论依据。方法选取2016年6月—2017年12月就诊于河北医科大学第二医院的急性脑梗死患者70例作为脑梗死组,依据美国国立卫生研究院卒中量表评分标准按严重程度分成轻型(NIHSS评分0~3分)组、中型(NIHSS评分4~15分)组、重型(NIHSS评分15分以上)组;选取同期性别、年龄匹配的健康体检者81例作为对照组。测量所有受检者血压,并抽取晨起空腹6h以上静脉血送同一机构测定SUA、血糖、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1(Apo A1)、载脂蛋白B(Apo B)、血浆纤维蛋白原(FIB)水平,分析脑梗死组与对照组各指标差异性,比较不同程度脑梗死患者SUA水平,Pearson相关分析SUA水平与NIHSS评分的相关性,Logistic回归分析上述各指标与脑梗死的关系。结果脑梗死组SBP、DBP、SUA、GLU、TC、TG、Apo B、FIB显著高于对照组(P均<0.05),Apo A1、HDL-C显著低于对照组(P均<0.05),LDL-C与对照组比较差异无统计学意义(P>0.05)。重度组、中度组、轻度组SUA水平分别为(476.47±47.16)μmol/L、(347.90±91.15)μmol/L、(250.69±75.66)μmol/L,重度组显著高于中度组(P<0.05),中度组显著高于轻度组(P<0.05)。Pearson相关分析显示SUA水平与神经功能缺失程度呈正相关(r=0.637,P<0.05)。在调整其他影响因素后,Logistic回归分析显示SUA是急性脑梗死的危险因素OR=10.430,95%CI(1.305,83.366),P<0.05]。结论SUA是急性脑梗死的独立危险因素,其与急性脑梗死的病情严重程度呈正相关,可直接影响急性脑梗死的预后。

Study on the correlation between serum uric acid level and the degree of neurological deficit in patients with acute cerebral infarction

Objective It is to investigate the correlation between serum uric acid(SUA)level and the severity of the disease in the patients with acute cerebral infarction,and to provide a theoretical basis for the prevention and treatment of acute stroke.Methods Seventy patients with acute cerebral infarction who were treated in the Second Hospital of Hebei Medical University from June 2016 to December 2017 were selected as the cerebral infarction group.They were divided into mild group(NIHSS scores 0 to 3 points),medium group(NIHSS score 4 to 15 points),severity group(NIHSS score above 15 points)according to the severity evaluated by the National Institutes of Health Stroke Scale.81 cases of gender-and age-matched health examinations were selected as the control group.The blood pressure of all subjects were detected,and their fasting venous blood for more than 6 hours was drawn in the morning to send to the same institution to measure the levels of SUA,blood glucose,total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),apolipoprotein A1(Apo A1),apolipoprotein B(Apo B),and plasma fibrinogen(FIB).The differences in the indexes between the cerebral infarction group and the control group were analyzed and compared.The level of SUA in the patients with different severe cerebral infarction was compared,Pearson correlation analysis was used to analyze the correlation between SUA level and NIHSS score,and Logistic regression analysis was used to analyze the relationship between the above indicators and cerebral infarction.Results The levels of SBP,DBP,SUA,GLU,TC,TG,Apo B,and FIB in the cerebral infarction group were significantly higher than those in the control group(P<0.05),and Apo A1 and HDL-C were significantly lower than those in the control group(P<0.05).There was no significant difference in LDL-C compared with the control group(P>0.05).The SUA levels in the severe group,moderate group,and mild group were(476.47±47.16)μmol/L,(347.90±91.15)μmol/L,and(250.69±75.66)μmol/L.The severe group was significantly higher than the moderate group(P<0.05),the moderate group was significantly higher than the mild group(P<0.05).Pearson correlation analysis showed that there was a positive correlation between the level of SUA and the degree of neurological deficits(r=0.637,P<0.05).After adjusting for other influencing factors,Logistic regression analysis showed that SUA was a risk factor for acute cerebral infarctionOR=10.430,95%CI(1.305,83.366),P<0.05].Conclusion SUA is an independent risk factor for acute cerebral infarction.It is positively correlated with the severity of acute cerebral infarction and can directly affect the prognosis of acute cerebral infarction.