Zhang Xiao-long, Zhang Jin-tao, Peng Ying, Xu Yan, Zhang Yong-hong
Department of Epidemiology and Biostatistics, School of Public Health, Soochow University, and The 88th Hospital of Jinan Military Command, Suzhou 215123, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2012 May;33(5):529-33.
To investigate the association between serum uric acid (SUA) and early clinical outcome among patients with acute stroke.
A total of 3231 acute stroke patients were included in the present study. Data on demographic characteristics, life style risk factors, history of disease, admission SUA and clinical outcome at discharge were collected for all participants. Poor clinical outcome was defined as neurologic deficiency (NIHSS≥10) at discharge or death during hospitalization.
Increased SUA level was associated with decreased risk of poor outcome among ischemic stroke patients. After adjustment for multivariate, the odds ratio (95% confidence interval) of poor outcome for every increased unit was 0.856 (0.795-0.898) among ischemic stroke patients. Logistic analysis was conducted according to quintile of SUA level, after adjustment for multi-variates, the odds ratio (95% confidence interval) of poor clinical outcome appeared to be associated with SUA of 197-241 µmol/L, 242-285 µmol/L, 286-346 µmol/L and ≥347 µmol/L, but were 0.552 (0.354-0.861), 0.417 (0.263-0.661), 0.390 (0.241-0.630) and 0.352 (0.213-0.581), respectively in those acute ischemic stroke patients, when compared to those with SUA<197 µmol/L. Among acute hemorrhagic stroke patients, after adjustment for multivariate, the odds ratio (95% confidence interval) of poor outcome for every increased unit was not significant among hemorrhagic stroke patients. According to the quintile of SUA level, when compared to those with SUA<150 µmol/L, the odds ratio (95% confidence interval) of poor clinical outcomes associated with SUA of 150-185 µmol/L, 186-230 µmol/L, 231-297 µmol/L and ≥298 µmol/L, were also not significant among those hemorrhagic stroke patients.
Elevated SUA seemed to be an independent predictor for short-term good clinical outcome among acute ischemic stroke patients.
探讨急性脑卒中患者血清尿酸(SUA)水平与早期临床结局之间的关联。
本研究共纳入3231例急性脑卒中患者。收集了所有参与者的人口统计学特征、生活方式风险因素、疾病史、入院时SUA水平及出院时的临床结局。不良临床结局定义为出院时神经功能缺损(美国国立卫生研究院卒中量表评分≥10分)或住院期间死亡。
缺血性脑卒中患者SUA水平升高与不良结局风险降低相关。多因素调整后,缺血性脑卒中患者SUA每升高一个单位,不良结局的比值比(95%置信区间)为0.856(0.795 - 0.898)。根据SUA水平五分位数进行逻辑回归分析,多因素调整后,与SUA<197 μmol/L的急性缺血性脑卒中患者相比,SUA为197 - 241 μmol/L、242 - 285 μmol/L、286 - 346 μmol/L和≥347 μmol/L的急性缺血性脑卒中患者不良临床结局的比值比(95%置信区间)分别为0.552(0.354 - 0.861)、0.417(0.263 - 0.661)、0.390(0.241 - 0.630)和0.352(0.213 - 0.581)。在急性出血性脑卒中患者中,多因素调整后,SUA每升高一个单位不良结局的比值比(95%置信区间)无统计学意义。根据SUA水平五分位数,与SUA<150 μmol/L的出血性脑卒中患者相比,SUA为150 - 185 μmol/L、186 - 230 μmol/L、231 - 297 μmol/L和≥298 μmol/L的出血性脑卒中患者不良临床结局的比值比(95%置信区间)也无统计学意义。
SUA升高似乎是急性缺血性脑卒中患者短期良好临床结局的独立预测因素。