Yang Yimin, Zhang Ying, Li Yanhua, Ding Lili, Sheng Lulu, Xie Zhijun, Wen Chengping
Department of Intensive Care Unit, First Hospital of Jilin University, Changchun, China.
Department of Neurology and Neuroscience Center, First Hospital of Jilin University, Changchun, China.
Cell Physiol Biochem. 2018;47(6):2369-2379. doi: 10.1159/000491609. Epub 2018 Jul 10.
BACKGROUND/AIMS: We sought to assess a consecutive number of patients with first-ever acute ischemic stroke (AIS), the clinical relevance in regard to functional outcome of the serum uric acid (SUA) measured at admission.
In 2 prospective centers for observational study, serum concentrations of SUA were measured on admission in the serum of 710 consecutive patients with AIS. SUA concentrations were determined by high-performance liquid chromatography. SUA, NIH stroke scale (NIHSS), and conventional risk factors were evaluated to determine their value to predict functional outcome within 3 months.
During the follow-up, an unfavorable functional outcome (defined as a mRS score > 2) was found in 219 (30.8%) patients. The unfavorable functional outcome distribution across the SUA quartiles ranged between 12.4% (third quartile) and 50.6% (first quartile). After adjusting for all other significant outcome predictors, SUA concentration remained an independent unfavorable outcome predictor with an adjusted OR of 0.996 (95% CI, 0.993-0.998; P< 0.001).
The data show that the U-shaped nature of the exposure-risk relationship was more prominent when the data were assessed in deciles (based on the SUA values). This model predicted the lowest relative risk of unfavorable outcome in the 67th percentile (corresponding to 309 µmol/L). SUA was significantly associated with the risk of poor functional outcomes in Chinese patients with stroke.
背景/目的：我们试图评估一系列首次发生急性缺血性卒中（AIS）的患者，探讨入院时测定的血清尿酸（SUA）水平与功能预后的临床相关性。
在2个前瞻性观察研究中心，对710例连续的AIS患者入院时的血清进行SUA浓度测定。SUA浓度通过高效液相色谱法测定。评估SUA、美国国立卫生研究院卒中量表（NIHSS）及传统危险因素，以确定它们在预测3个月内功能预后方面的价值。
随访期间，219例（30.8%）患者出现不良功能预后（定义为改良Rankin量表评分>2分）。SUA四分位数区间内不良功能预后的分布在12.4%（第三四分位数）至50.6%（第一四分位数）之间。在对所有其他显著的预后预测因素进行校正后，SUA浓度仍然是独立的不良预后预测因素，校正后的比值比为0.996（95%可信区间，0.993 - 0.998；P<0.001）。
数据显示，当以十分位数（基于SUA值）评估数据时，暴露-风险关系的U形特征更为突出。该模型预测在第67百分位数（对应309µmol/L）时不良预后的相对风险最低。SUA与中国卒中患者功能预后不良的风险显著相关。
