Arévalo-Lorido José Carlos, Carretero-Gómez Juana, Robles Nicolás Roberto
a Internal Medicine Department , Zafra County Hospital , Badajoz , Spain.
b Nephrology Department , University Hospital Infanta Cristina , Badajoz , Spain.
Int J Neurosci. 2018 Oct;128(10):906-912. doi: 10.1080/00207454.2018.1441150. Epub 2018 Feb 26.
The relationship between serum uric acid (SUA) levels and stroke is controversial. The discrepancies in the results could be due to the uneven setting of comorbidity. It is known that hyperuricaemia increases in parallel with the decline in renal function; however, there are few studies that adjust for renal disease.
To investigate the relationship between SUA levels in the acute phase of ischaemic stroke according to the presence or absence of chronic kidney disease and clinical outcomes during admission.
Retrospective cross-sectional analysis of patients recruited through a unicentric stroke registry. The sample was divided according to its quartiles of SUA. Renal disease was defined based on the haematocrit, urea and Gender (HUGE) formula. The outcome was determined by the National Institutes of Health Stroke Scale (NIHSS) score. Statistically robust methods were used with R (version 3.3.2).
A total of 412 patients (53.8% male) were analysed. The NIHSS score decreased as the SUA levels increased (p < 0.0009). Robust linear regression analysis showed a significant association between quantitative SUA levels and NIHSS score (p < 0.0003), even when patients were categorized according to renal function (p < 0.05). In an adjusted multivariate model, SUA levels showed an independent protective effect on the severity of stroke (OR = 0.67, 95% CI 0.51-0.88, p = 0.004).
Our results support the hypothesis that hyperuricaemia plays a protective role in the prognosis of stroke, independently from renal function, and that even in patients with chronic kidney disease, it remains as a protective agent.
血清尿酸（SUA）水平与中风之间的关系存在争议。结果的差异可能是由于合并症的设定不均衡。已知高尿酸血症与肾功能下降并行增加；然而，很少有研究对肾脏疾病进行校正。
根据是否存在慢性肾病及住院期间的临床结局，研究缺血性中风急性期SUA水平之间的关系。
对通过单中心中风登记处招募的患者进行回顾性横断面分析。样本根据SUA四分位数进行划分。根据血细胞比容、尿素和性别（HUGE）公式定义肾脏疾病。结局由美国国立卫生研究院中风量表（NIHSS）评分确定。使用R（版本3.3.2）采用统计学稳健方法。
共分析了412例患者（53.8%为男性）。随着SUA水平升高，NIHSS评分降低（p<0.0009）。稳健线性回归分析显示定量SUA水平与NIHSS评分之间存在显著关联（p<0.0003），即使根据肾功能对患者进行分类时也是如此（p<0.05）。在调整后的多变量模型中，SUA水平对中风严重程度显示出独立的保护作用（OR=0.67，95%CI 0.51-0.88，p=0.004）。
我们的结果支持以下假设，即高尿酸血症在中风预后中起保护作用，独立于肾功能，并且即使在慢性肾病患者中，它仍然是一种保护剂。
