Department of Neurology, University Medical Center Groningen, University of Groningen, The Netherlands.
J Neurol Sci. 2012 Aug 15;319(1-2):51-5. doi: 10.1016/j.jns.2012.05.019. Epub 2012 May 26.
The prognostic value of serum uric acid (UA) in acute ischemic stroke is controversial. The aim of this study is to further analyse the relation between UA and outcome after acute ischemic stroke.
We analysed UA levels in blood samples collected within 6h of stroke onset from patients included in the placebo arm of the US and Canadian Lubeluzole Ischemic Stroke Study (LUB-INT-9). We compared mean serum UA levels in patients with and without early neurological improvement (≥ 4 versus <4 points improvement on NIHSS after 5 days) and in patients with good functional and poor functional outcome (mRS 0-2 versus mRS 3-6). Multivariable logistic regression analyses were performed to adjust for possible confounders.
UA levels of 226 patients were available for analysis. Mean serum UA levels were not significantly higher in patients with than without early neurological improvement (0.33 mmol/L versus 0.30 mmol/L, p=0.070). The difference between patients with good and patients with poor functional outcome was borderline statistically significant (0.34 mmol/L versus 0.31 mmol/L, p=0.050). After adjustment for confounders, higher serum UA levels were neither associated with early neurological improvement OR (1.30, 95% CI 0.98-1.73, p=0.069), nor with a good functional outcome (OR 1.09, 95% CI 0.72-1.65, p=0.690).
We found no association between admission serum UA levels and both short- and long-term outcome in acute ischemic stroke.
血清尿酸（UA）在急性缺血性卒中中的预后价值存在争议。本研究旨在进一步分析 UA 与急性缺血性卒中后结局的关系。
我们分析了纳入美国和加拿大卢贝卢唑缺血性卒中研究（LUB-INT-9）安慰剂组的患者卒中发作后 6 小时内采集的血样中 UA 水平。我们比较了早期神经功能改善（NIHSS 评分在 5 天后增加≥4 分与<4 分）和功能结局良好与不良的患者（mRS 0-2 分与 mRS 3-6 分）之间的平均血清 UA 水平。进行多变量逻辑回归分析以调整可能的混杂因素。
226 例患者的 UA 水平可用于分析。与无早期神经功能改善的患者相比，有早期神经功能改善的患者的血清 UA 水平无显著升高（0.33mmol/L 与 0.30mmol/L，p=0.070）。有良好功能结局与不良功能结局的患者之间的差异具有统计学意义的边界（0.34mmol/L 与 0.31mmol/L，p=0.050）。在调整混杂因素后，较高的血清 UA 水平与早期神经功能改善（OR 1.30，95%CI 0.98-1.73，p=0.069）或良好的功能结局（OR 1.09，95%CI 0.72-1.65，p=0.690）均无相关性。
我们未发现入院时血清 UA 水平与急性缺血性卒中的短期和长期结局之间存在关联。
