Prognostic Significance of Uric Acid Levels in Ischemic Stroke Patients
Prognostic Significance of Uric Acid Levels in Ischemic Stroke Patients
复制标题
缺血性中风患者尿酸水平的预后意义
DOI：
10.1007/s12640-015-9561-9
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发表时间：
2015-09
影响因子：
3.7
通讯作者：
Lu TaoSheng
中科院分区：
文献类型：
--
作者：
Zhang Xia;Huang ZhiChao;You ShouJiang;Cao YongJun;Liu Chunfeng;Lu TaoSheng
血清尿酸(UA)水平在心血管疾病或中风患者中的重要性和作用尚不清楚。我们试图评估卒中患者合适的UA水平，以及内源性UA水平与急性缺血性卒中(AIS)患者临床结局之间的关系，特别是关于性别和UA水平之间可能存在的相互作用对AIS预后的影响。我们检查了303名在48小时内发生缺血性中风的患者，其中101名患者接受了溶栓治疗。入院后第2天清晨测定血清尿酸(μ摩尔/L)水平。临床起病90天后用改良Rankin评分评估患者预后。根据血清尿酸四分位数将患者分为四组。二元多变量Logistic回归模型用于评估与功能结局和内源性UA水平有关的临床相关性。按性别和正常肾小球滤过率进行亚组分析。不良的功能结局与高龄、房颤史或较高的美国国立卫生研究院卒中基线评分有关。在调整潜在混杂因素后，与基线组(UA水平316-380μ摩尔/L)相比，尿酸水平较高(≤250：μ摩尔/L)或较低血尿酸水平(μ250：≤摩尔/L)的患者发生不良预后的可能性增加2-3倍(OR2.95，95%可信区间1.14-7.61；或2.78，95%可信区间1.02-7.58)。在溶栓患者中也观察到了同样的结果。与基线组相比，UA水平高和低的患者预后不良的可能性增加9-18倍(UA水平分别为316-380Mol/μ/L；OR18.50，95%CI：2.041-167.67；OR9.66，95%CI1.42-65.88)。在男性中，UA水平高的患者预后不良的可能性是基线组的6倍(UA水平：279-334μ摩尔/L；OR 6.10，95%可信区间1.62-22.93)。然而，与基线组相比，UA水平为271-337μ摩尔/L的女性患者表现不佳的可能性是基线组的7倍(UA水平和μ摩尔/L，OR 7.06，95%可信区间1.00-49.81)。血清UA水平在适当范围内与AIS患者较好的预后相关，但太高或太低可能是有害的。尿酸水平与AIS预后的相关性在男性和女性患者中不同，这突显了在脑血管危险因素调查中按性别分层的必要性。
The importance and function of serum uric acid (UA) levels in patients with cardiovascular disease or stroke are unclear. We sought to evaluate the appropriate UA levels for stroke patients and the association between endogenous UA levels and clinical outcomes in acute ischemic stroke (AIS) patients, particularly regarding the possible interaction between gender and UA levels with respect to AIS prognosis. We examined 303 patients who had an onset of ischemic stroke within 48 h. Of those, 101 patients received thrombolytic treatment. Serum UA (μmol/L) levels were measured the second morning after admission. Patient prognosis was evaluated 90 days after clinical onset by modified Rankin Scale. Patients were divided into four groups according to serum UA quartiles. A binary multivariate logistic regression model was used to assess clinical relevance in regard to functional outcome and endogenous UA levels. Analysis of subgroups by gender and normal glomerular filtration rate were also been done. Poor functional outcome was associated with older age, history of atrial fibrillation, or higher baseline National Institutes of Health Stroke Scale scores. After adjustment for potential confounders, patients with higher UA levels (>380 μmol/L) or lower UA levels (≤250 μmol/L) were 2–3 times more likely to have a poor outcome (OR 2.95, 95 % CI 1.14–7.61; OR 2.78, 95 % CI 1.02–7.58, respectively) compared to the baseline group (UA level 316–380 μmol/L). The same results were observed in thrombolyzed patients. Patients with high and low UA levels were 9–18 times more likely to having poor outcomes compared to the baseline group (UA level: 316–380 μmol/L; OR 18.50, 95 % CI: 2.041–167.67; OR 9.66, 95 % CI 1.42–65.88, respectively). In men, patients with high UA levels were 6 times more likely to have poor outcomes compared to the baseline group (UA level: 279–334 μmol/L; OR 6.10, 95 % CI 1.62–22.93). However, female patients with UA level 271–337 μmol/L were seven times more likely to perform badly compared to the baseline group (UA level >337 μmol/L, OR 7.06, 95 % CI 1.00–49.81). Serum UA levels in an appropriate range were associated with better outcome in patients with AIS but may be harmful when too high or too low. The association of UA levels with AIS prognosis differed in male and female patients, which highlights the necessity of stratifying by gender in investigations of cerebrovascular risk factors.
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影响因子：
8.3
作者：
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通讯作者：
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