Wu Hongliang, Jia Qian, Liu Gaifen, Liu Liping, Pu Yuehua, Zhao Xingquan, Wang Chunxue, Wang Yilong, Wang Yongjun
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
J Stroke Cerebrovasc Dis. 2014 Mar;23(3):469-75. doi: 10.1016/j.jstrokecerebrovasdis.2013.04.007. Epub 2013 Jun 2.
The relationship between uric acid and stroke prognosis is ambiguous. Some studies have explored this relationship in acute stroke but have different results. In this study, we explored the relationship between uric acid levels and 1-year outcomes and vascular events of acute ischemic stroke patients and cerebral hemorrhage patients.
In all, 1452 continued first, acute ischemic stroke patients and 380 continued cerebral hemorrhage patients were admitted to our hospitals. Serum uric acid concentrations were measured in 1351 ischemic stroke patients and 380 cerebral hemorrhage patients at admission. We evaluated the relationship between uric acid levels and outcomes (modified Rankin scale [mRS] > 2, all-cause death, vascular events, stroke recurrent) at 14 days, 90 days, and 1 year after stroke onset.
The median uric acid concentration was 303.0 μmol/L in ischemic stroke patients and 269 μmol/L in cerebral hemorrhage patients. In univariate analysis, uric acid levels were not correlated with outcomes in cerebral hemorrhage patients. We used multiple logistic regression analysis to show that lower serum uric acid levels independently predicted poor functional outcomes (mRS >2) at 1 year after ischemic stroke onset (odds ratio [OR] = .335, 95% confidence interval [CI]: .164-.684, P = .003). Also, lower serum uric acid levels were independently correlated with vascular events in the first year in ischemic stroke patients. By multiple cox proportional hazards analysis, we obtained data which reveal that serum uric acid levels were not correlated with all-cause death (OR = .992, 95% CI: .683-1.443, P = .969) in ischemic stroke patients.
Serum uric acid may be neuroprotective in acute ischemic stroke patients.
尿酸与中风预后之间的关系尚不明确。一些研究已在急性中风中探究了这种关系，但结果各异。在本研究中，我们探究了急性缺血性中风患者和脑出血患者的尿酸水平与1年预后及血管事件之间的关系。
共有1452例连续性首发急性缺血性中风患者和380例连续性脑出血患者入住我院。对1351例缺血性中风患者和380例脑出血患者入院时测定血清尿酸浓度。我们评估了中风发作后14天、90天和1年时尿酸水平与预后（改良Rankin量表[mRS]>2、全因死亡、血管事件、中风复发）之间的关系。
缺血性中风患者的尿酸浓度中位数为303.0μmol/L，脑出血患者为269μmol/L。在单因素分析中，尿酸水平与脑出血患者的预后无关。我们采用多因素逻辑回归分析显示，较低的血清尿酸水平可独立预测缺血性中风发作后1年时不良功能预后（mRS>2）（比值比[OR]=0.335，95%置信区间[CI]：0.164 - 0.684，P = 0.003）。此外，较低的血清尿酸水平与缺血性中风患者第一年的血管事件独立相关。通过多因素Cox比例风险分析，我们获得的数据显示缺血性中风患者的血清尿酸水平与全因死亡无关（OR = 0.992，95%CI：0.683 - 1.443，P = 0.969）。
血清尿酸可能对急性缺血性中风患者具有神经保护作用。
