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血清尿酸水平与老年人腔隙性梗死的关系。

Association Between the Serum Uric Acid Levels and Lacunar Infarcts in the Elderly.

机构信息

Department of Life, Health & Environmental Sciences, University of L'Aquila, Coppito, L'Aquila, Italy.

Clinical Laboratory, Avezzano's Hospital, Avezzano, Italy.

出版信息

J Mol Neurosci. 2018 Jul;65(3):385-390. doi: 10.1007/s12031-018-1096-0. Epub 2018 Jul 4.

Abstract

Increasing evidence suggests that uric acid (UA) is a relevant risk factor for arteriolosclerosis and recent studies have demonstrated the positive relationship between UA concentrations and the severity of leukoaraiosis. However, the association between lacunar infarcts (LI) and UA levels has seldom been reported in the literature. The aim of our study was to assess whether serum UA levels may be related to the presence of LI. We recruited 242 patients (113 males and 129 females, aged 82.83 ± 6.49 years) from our Geriatric Department for whom CAT scans (CT) were available. Clinical and laboratory data was collected. Patients CT images were examined to identify the presence, the size, the number, and the location of LI. LI without neurological symptoms were considered silent LI. Serum UA levels were found to be positively associated with the presence (p = 0.0001), the number (p = 0.001), the size (p = 0.001), and the location of LI in the basal ganglia (p = 0.0038), the deep white matter (DWM) (p < 0.0001), and the pons (p = 0.0156). A significant association was also found between UA and silent LI (p = 0.0002). The prevalence of LI increased starting from UA levels of 5.7 mg/dl. Stepwise multiple regression analysis confirmed that UA was independently related with the presence, the number, the size, LI in the basal ganglia, the DWM, the pons, and with silent LI. Our study suggests a positive association between UA levels and LI, which is independent of traditional cardiovascular risk factors. This data suggests that UA plays an influential role on the physiopathology of LI and could represent a potential target to prevent cerebral microinfarcts.

摘要

越来越多的证据表明尿酸(UA)是动脉硬化的一个相关危险因素,最近的研究表明 UA 浓度与脑白质疏松症的严重程度之间存在正相关关系。然而,在文献中很少有报道腔隙性梗死(LI)与 UA 水平之间的关系。我们的研究旨在评估血清 UA 水平是否与 LI 的存在有关。我们从老年科招募了 242 名患者(113 名男性和 129 名女性,年龄 82.83±6.49 岁),他们的 CAT 扫描(CT)可供检查。收集了临床和实验室数据。检查患者的 CT 图像以确定 LI 的存在、大小、数量和位置。没有神经症状的 LI 被认为是无症状性 LI。UA 水平与 LI 的存在(p=0.0001)、数量(p=0.001)、大小(p=0.001)和基底节(p=0.0038)、深部白质(DWM)(p<0.0001)和脑桥(p=0.0156)的位置呈正相关。UA 与无症状性 LI 之间也存在显著相关性(p=0.0002)。LI 的患病率从 UA 水平为 5.7mg/dl 开始增加。逐步多元回归分析证实,UA 与 LI 的存在、数量、大小、基底节 LI、DWM、脑桥和无症状性 LI 独立相关。我们的研究表明 UA 水平与 LI 之间存在正相关关系,这与传统的心血管危险因素无关。这些数据表明 UA 在 LI 的病理生理学中起着重要作用,可能是预防脑微梗死的潜在靶点。

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