高尿酸血症与老年脑梗死的关系探讨

目的：讨论高尿酸血症（HUA）与老年脑梗死及其神经功能缺损程度的关系。方法选择2012年10月-2014年2月北京市回民医院（以下简称“我院”）110例老年急性脑梗死患者作为研究组,并选择同期我院56例健康体检者作为对照组。检测并比较两组血尿酸（UA）、低密度脂蛋白胆固醇（LDL-C）、血糖（Glu）、收缩压（SBP）、舒张压（DBP）水平,研究血UA水平与患者病情严重程度的关系。结果①研究组患者血浆UA、LDL-C、Glu水平[（343.65±70.15）μmol/L、（3.28±0.49）mmol/L、（6.45±1.55）mmol/L]均显著高于对照组[（259.55±74.58）μmol/L、（2.58±0.42）mmol/L、（5.92±1.34）mmol/L],差异有统计学意义（P〈0.05或〈0.01）。②多因素Logistic回归分析结果显示,血UA水平升高（OR=1.020,95%CI：1.011-1.030）、高血压（OR=1.206,95%CI：1.091-1.333）、糖尿病（OR=1.678,95%CI：1.052-2.676）和高LDL-C血症（OR=2.473,95%CI：1.252-3.676）是老年脑梗死的独立危险因素。③研究组中随着病情程度分层递增,血UA水平逐步增高,差异有高度统计学意义（〈0.01）。结论 HUA是老年脑梗死的独立、可干预的危险因素,并可提示老年脑梗死病情的严重程度。

Discussion on the relationship between hyperuricemia and cerebral infarc-tion in elderly

Objective To investigate the relationship between hyperuricemia （HUA） and cerebral infarction in the elderly and the degree of neurological deficit. Methods 110 elderly patients with cerebral infarction from October 2012 to February 2014 in the Muslim Hospital of Beijing （“our hospital” for short） were selected as study group, and 56 healthy persons in the same period in our hospital were enrolled as control group. The levels of blood uric acid （UA）, low density lipoprotein cholesterol （LDL-C）, blood glucose （Glu）, SBP, DBP in the two groups were measured and compared, and the relationship between the levels of serum UA and the severity of the disease was studied. Results① The serum levels of UA, LDL-C, Glu in study group [（343.65±70.15）μmol/L, （3.28±0.49） mmol/L, （6.45±1.55） mmol/L] were higher than those of the control group [（259.55±74.58） μmol/L, （2.58±0.42） mmol/L, （5.92±1.34） mmol/L], the differences were statistically significant （P〈0.05 or 〈0.01）.②Multivariate Logistic regression analysis showed that high levels of the UA （OR=1.020, 95%CI：1.011-1.030）, hypertension （OR=1.206, 95%CI：1.091-1.333）, diabetes （OR=1.678, 95%CI：1.0052-2.676）, and high levels of low-density protein （OR=2.473, 95%CI：1.252-3.676） were independent risk factors of cerebral infarction in elderly.③With the severity increasing, the blood uric acid level elevated gradually in patients, the differences were statistically significant （P〈 0.01）. Conclusion HUA is an independent and preventive intervention risk factor for cerebral infarction in the elderly and may predict the severity of cerebral infarction in the elderly.