中年脑梗死患者高尿酸血症与复发的关系

目的探讨中年脑梗死患者基线高尿酸血症与1年内脑梗死复发之间的关系。方法收集253例1周内首发中年急性脑梗死患者的临床资料,根据基线尿酸水平分为高尿酸血症组(n=63)及正常尿酸组(n=190),采用前瞻性队列研究,比较2组患者基线临床资料及1年内脑梗死复发比例。结果 2组患者中性别、高血压病史、糖尿病史、总胆固醇(TC)、三酰甘油(TG)等指标比较差异具有统计学意义(P<0.05),而年龄、冠心病、心房纤颤、吸烟、饮酒、家族史、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、空腹血糖(FPG)、纤维蛋白原(Fib)、血清肌酐(SCr)、血清白蛋白(Alb)、血小板计数(PLT)、尿蛋白定性等指标比较差异无统计学意义(P>0.05)。进一步相关性分析提示血尿酸与TC、TG具有相关性(r=0.378、0.302,P<0.05)。1年内复发26例,总体复发率为10.3%,其中高尿酸血症组为17.5%(11/63),正常尿酸组为7.9%(15/190),通过Kaplan-Meier法(乘积极限法)分析提示,2组差异具有统计学意义(Log-rank=4.88,P=0.027)。结论中年脑梗死患者尿酸水平受多种因素影响,而基线高尿酸血症增加脑梗死复发风险,因此应该采取综合干预措施,以减少脑梗死复发。

The relatioshoip between hyperuricemia and infarction recurrence in middle aged cerebral infarction

Objective To investigate the relationship between middle-aged cerebral infarction patients with baseline hyperuricemia and within 1 years of the recurrence of cerebral infarction.Methods Collected the clinical data of 253 middle age patients with acute cerebral infarction within 1 weeks,according to baseline levels of uric acid to divide into hyperuricemia group（n=63） and normal uric acid group（n=190）,a prospective cohort study,compared the clinical data and 1 years proportion of recurrent cerebral infarction of the 2 groups.Results Two groups of patients＇ gender,history of hypertension,history of diabetes,total cholesterol（TC）,triglyceride（TC） was statistically significant differences（P〈0.05）,age,coronary heart disease,atrial fibrillation,smoking,drinking,family history,low density lipoprotein cholesterol（LDL-C）,high density lipoprotein cholesterol（HDL-C）,fasting blood glucose（FPG）,fibrinogen（Fib）,serum creatinine（SCr）,serum albumin（Alb）,platelet count（PLT） and proteinuria qualitative test showed no significant differences（P〉0.05）.Further correlation analysis suggested that serum uric acid and TC,TG has correlation（r=0.378,r=0.302,P〈0.05）.1 years recurrence in 26 cases,the recurrence rate was 10.3%,the hyperuricemia group was 17.5%（11/63）,normal uric acid group was 7.9%（15/190）,by Kaplan-Meier method（product limit method） analysis suggested that,with significant difference between 2 groups（Log-rank=4.88,P=0.027）.Conclusion Middle-aged cerebral infarction patients＇ uric acid level is affected by many factors,and the baseline hyperuricemia increases the risk of recurrent cerebral infarction,therefore it should take comprehensive therapy to reduce the recurrence of cerebral infarction.