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[rt-PA静脉溶栓治疗的脑卒中患者血清尿酸水平与临床结局及出血性转化的相关性研究]

[Association study of serum uric acid levels with clinical outcome and hemorrhagic transformation in stroke patients with rt-PA intravenous thrombolysis].

作者信息

Yu Xiaoyan, Shi Jijun, Jiang Chunli, Xu Jiaping, You Shoujiang, Cao Yongjun, Liu Chunfeng

机构信息

Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China.

Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China; Email:

出版信息

Zhonghua Yi Xue Za Zhi. 2015 Aug 4;95(29):2351-4.

Abstract

OBJECTIVE

To evaluate the relation of serum uric acid levels on admission with short-term clinical outcome and hemorrhagic transformation (HT) in patients with acute ischemic stroke treated with thrombolysis.

METHODS

A total of 230 acute ischemic stroke patients treated with thrombolysis in our stroke unit from 2010 to 2013 were included. Demographics, disease severity, the uric acid levels on admission and hemorrhagic transformation were prospectively collected. At 90 days, the scores of the modified Rankin Scale>2 (mRS>2) was defined as poor prognosis and the scores of mRS≤2 was defined as excellent outcome. Stepwise Logistic regression models were used to analyze potential factors affecting the prognosis.

RESULTS

The levels of serum uric acid in the patients with excellent outcome were significantly higher than in patients with poor outcome [(375±42) µmol/L vs (250±36) µmol/L, P=0.0026]. Logistic regression analysis revealed that high level of serum uric acid was related to excellent outcome (OR=1.25, 95% CI, 1.04-1.47, P=0.013). The serum uric acid level of non HT patients was significantly higher than the HT patients [(350±51) µmol/L vs (282±38) µmol/L, P=0.015]. After adjustment for the influence factors including age and hypertension, the level of uric acid was still negatively correlated with HT.

CONCLUSION

Increased serum uric acid levels are associated with low incidence of HT and better prognosis in patients with stroke treated with reperfusion therapy.

摘要

目的

评估急性缺血性脑卒中溶栓治疗患者入院时血清尿酸水平与短期临床结局及出血性转化(HT)的关系。

方法

纳入2010年至2013年在我院卒中单元接受溶栓治疗的230例急性缺血性脑卒中患者。前瞻性收集患者的人口统计学资料、疾病严重程度、入院时尿酸水平及出血性转化情况。90天时,改良Rankin量表评分>2(mRS>2)定义为预后不良,mRS≤2定义为预后良好。采用逐步Logistic回归模型分析影响预后的潜在因素。

结果

预后良好患者的血清尿酸水平显著高于预后不良患者[(375±42)μmol/L vs(250±36)μmol/L,P = 0.0026]。Logistic回归分析显示,血清尿酸水平高与预后良好相关(OR = 1.25,95%CI,1.04 - 1.47,P = 0.013)。非HT患者的血清尿酸水平显著高于HT患者[(350±51)μmol/L vs(282±38)μmol/L,P = 0.015]。在调整年龄和高血压等影响因素后,尿酸水平仍与HT呈负相关。

结论

血清尿酸水平升高与再灌注治疗的脑卒中患者HT发生率低及预后较好相关。

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