Karagiannis Asterios, Mikhailidis Dimitri P, Tziomalos Konstantinos, Sileli Maria, Savvatianos Savvas, Kakafika Anna, Gossios Thomas, Krikis Napoleon, Moschou Irene, Xochellis Michael, Athyros Vassilios G
Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece.
Circ J. 2007 Jul;71(7):1120-7. doi: 10.1253/circj.71.1120.
The prognostic significance of uric acid (UA) levels in acute stroke is unclear, so the objective of this study was to determine the association between levels of serum UA (SUA) and mortality in acute stroke.
Consecutive patients (n=435) presenting with ischemic stroke and intracerebral hemorrhage were included in the study. The length of stay in hospital and the occurrence of death were recorded. On univariate analysis, the occurrence of death was associated with older age, smoking, presence of congestive heart failure or atrial fibrillation, absence of hyperlipidemia, and intracerebral hemorrhage as the index event. Furthermore, glucose, urea, creatinine and SUA at admission were significantly higher in patients who died, whereas total and high-density-lipoprotein cholesterol were significantly lower. On multiple logistic regression analysis, the independent relationship between higher SUA levels and death was confirmed (odds ratio (OR), 1.37; 95%confidence interval (CI), 1.13-1.67; p=0.001). The only other variables independently associated with the occurrence of death were urea concentration and presence of atrial fibrillation. If urate was >7.8 mg/dl (0.47 mmol/L), then there would be a high probability of early death (87%).
Elevated levels of SUA are independently associated with an increased risk of early death in acute stroke.
急性卒中患者尿酸（UA）水平的预后意义尚不清楚，因此本研究的目的是确定血清尿酸（SUA）水平与急性卒中死亡率之间的关联。
本研究纳入了连续的435例缺血性卒中和脑出血患者。记录住院时间和死亡情况。单因素分析显示，死亡的发生与年龄较大、吸烟、存在充血性心力衰竭或心房颤动、无高脂血症以及脑出血作为索引事件有关。此外，死亡患者入院时的血糖、尿素、肌酐和SUA显著升高，而总胆固醇和高密度脂蛋白胆固醇显著降低。多因素逻辑回归分析证实了较高的SUA水平与死亡之间的独立关系（比值比（OR）为1.37；95%置信区间（CI）为1.13 - 1.67；p = 0.001）。唯一与死亡发生独立相关的其他变量是尿素浓度和心房颤动的存在。如果尿酸>7.8 mg/dl（0.47 mmol/L），则早期死亡的可能性很高（87%）。
SUA水平升高与急性卒中早期死亡风险增加独立相关。
