尿酸对急性缺血性卒中患者血管再通和梗死体积的影响

目的 探讨急性缺血性卒中患者尿酸（UA）浓度的变化对血管再通和梗死体积的影响.方法 对176例发病24 h内患者应用弥散加权磁共振（DWI）检查,证实为前循环急性缺血性卒中.经改良的NIH卒中（mNIHSS）评分5分以上,随访观察尿酸、尿囊素（尿酸的非酶代谢产物）浓度的变化对血管再通和梗死体积的影响.结果 66例血管再通病人多数接受溶栓治疗,UA浓度在48 h降低,然后逐渐升高呈U行改变,14 d时mNIHSS评分降低,UA和尿囊素浓度变化与DWI梗死体积明显相关.结论 UA是急性缺血性卒中的一种消耗和再生性抗氧化剂,其浓度变化与血管再通和梗死体积有关.

Influence of uric acid on the recanalization and infarct volume in patients with acute ischemic stroke

Objective To explore changes of concentration of uric acid on the recanalization and infarct volume in patients with acute ischemic stroke. Methods 176 cases within 24 hours of onset,diagnosed as the acute ischemic stroke in the anterior circulation system by diffusion weighted magnetic resonance imaging （DWI） and with modified NIH Stroke Scale（mNIHSS） score 5 or greater,were followed--up and explored the effect of the changes of uric acid（UA） and allantion（a nonenzymatic me tabolite of UA） levels on recanalization and infarct volume by DWI. Results Most of 66 cases with recanalized vessels were re- ceived thrombolytic therapy, and the UA levels dropped at 48 hours and then gradually increased in a U-shaped pattern. At 14day mNIHSS scores reducted, and concentration of UA and allantoin was significantly related with infarct volume by DWI. Conclusion UA might be a kind of consumptive and regenerative antioxidants in acute ischemic stroke, and its concentration changes is related with recanalization and infarct volume.