血清尿酸、颈动脉硬化与脑梗死严重程度的相关性探讨

目的：探讨血清尿酸、颈动脉粥样硬化（CAS）与急性脑梗死（ACI）严重程度的相关性。方法：收集 ACI患者123例，根据神经缺损评分分为轻、中、重3组，分别为56、39、28例，另有40例健康体检者为健康组。所有对象来院时予即刻抽血检验血清尿酸（UA）水平，并行颈动脉超声检查，记录颈动脉内-中膜厚度（IMT）、斑块情况，并计算 Crouse 积分。结果：中、重度组的血 UA 水平、斑块检出率、不稳定性斑块形成率较轻度组、健康组均显著升高。中度组的 IMT、Crouse 积分水平显著高于健康组，重度组的 IMT、Crouse 积分水平较健康、轻度、中度组均显著升高。ACI 患者的血 UA 水平与 IMT、Crouse 积分水平呈正相关，稳定性、不稳定性斑块 ACI 患者 UA 水平较无斑块者显著升高，其中不稳定性斑块组 UA 水平较稳定性斑块组进一步升高。结论：血尿酸升高促进颈动脉粥样硬化斑块的形成。尿酸水平越高，斑块性质可能越不稳定，脑梗死发生时程度可能更严重。

The Correlation among Serum Uric Acid,Carotid Atherosclerosis and the Disease Severity in Cerebral Infarction

Obejective To explore the correlation among serum uric acid (UA), carotid atherosclerosis (CAS) and the disease severity in acute cerebral infarction (ACI). Methods Collecting 123 ACI patients and dividing them into three groups, including 56 mild patients, 39 moderate patients and 28 severe patients.40 healthy physical examinees were set as healthy group. All were examined with serum UA once they visited hospital. Carotid ultrasound was done and intima-media thickness (IMT), plaque and crouse integration were recorded. Results The UA levels, detection rate of plaque and unstable plaque in both moderate and severe group were significantly higher than the mild and healthy group. The IMT and crouse integration of moderate group were higher than the healthy group. Similarly, the two indexes in severe group obviously increased versus the healthy, mild and moderate group. Positive correlations were found between UA level and IMT, as well between UA level and crouse integration . And the UA levels of the ACI patients with stable and unstable plaques were both significantly higher than the patients without plaques, while that of the unstable ones increased further versus the stable . Conclusion Elevation of the serum UA level may promote the formation of CAS plaques. The higher the UA level, the less stable the plaque, which may result in more serious cerebral infarction.