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血清尿酸在非洲黑人出血性中风患者急性期的预后价值

The prognostic value of serum uric acid in the acute phase of hemorrhagic stroke patients in black Africans.

作者信息

Mapoure Yacouba Njankouo, Ayeah Chia Mark, Ba Hamadou, Ngahane Hugo Bertrand Mbatchou, Hentchoya Romuald, Luma Henry Namme

机构信息

Department of Clinical Sciences, University of Douala, Douala, Cameroon.

Department of Internal Medicine, Douala General Hospital, Douala, Cameroon.

出版信息

Pan Afr Med J. 2019 Apr 9;32:165. doi: 10.11604/pamj.2019.32.165.15107. eCollection 2019.

Abstract

INTRODUCTION

Very few studies have been conducted to evaluate the prevalence of hyperuricemia and its impact on the prognosis amongst acute hemorrhagic stroke (AHS) patients. The objectives was to determine the prevalence of hyperuricemia in AHS patients and examined the association between hyperuricemia and stroke outcomes in the Douala General Hospital (DGH).

METHODS

This was a hospital based prospective cohort which included AHS patients with baseline SUA levels and 3 months post stroke follow-up data. SUA values were divided into quintiles. Associations between hyperuricemia and stroke outcomes were analyzed using multiple logistic regression and survival analysis (cox regression and Kaplan Meier).

RESULTS

A total of 221 AHS patients were reviewed with a mean age of 55.8±11.8 years. The prevalence of hyperuricemia among AHS patients was 34.4% with mean SUA level of 376.8±131.9 μmol/l. On multivariate analysis, hyperuricemia was not independently associated with early death [(OR = 1.072 (CI: 0.370-3.056; p = 0.897)] and poor functional outcome [(OR=2.487 (CI: 0.771-8.699; p = 0.154)] after hemorrhagic stroke. No significant increase in stroke deaths was observed across higher SUA quintiles amongst hemorrhagic stroke patients (p = 0.326). No statistically significant correlation was observed between SUA level and NIHSS (r = 0.063, p = 0.353) and between SUA level and mRS (r = 0.030, p = 0.662) in hemorrhagic stroke.

CONCLUSION

About one third of patients present with hyperuricemia in the acute phase of hemorrhagic stroke. Hyperuricemia can act as risk factor for stroke because of its relationship with CVRFs but hyperuricemia has no impact on the severity and short-term outcome amongst black African hemorrhagic stroke patients.

摘要

引言

很少有研究评估急性出血性卒中(AHS)患者高尿酸血症的患病率及其对预后的影响。目的是确定杜阿拉总医院(DGH)AHS患者高尿酸血症的患病率,并研究高尿酸血症与卒中结局之间的关联。

方法

这是一项基于医院的前瞻性队列研究,纳入了有基线血尿酸水平及卒中后3个月随访数据的AHS患者。血尿酸值分为五分位数。使用多元逻辑回归和生存分析(cox回归和Kaplan Meier)分析高尿酸血症与卒中结局之间的关联。

结果

共纳入221例AHS患者,平均年龄55.8±11.8岁。AHS患者中高尿酸血症的患病率为34.4%,平均血尿酸水平为376.8±131.9μmol/l。多因素分析显示,高尿酸血症与出血性卒中后的早期死亡[比值比(OR)=1.072(95%置信区间:0.370-3.056;P=0.897)]和功能预后不良[OR=2.487(95%置信区间:0.771-8.699;P=0.154)]无独立相关性。在出血性卒中患者中较高的血尿酸五分位数组中未观察到卒中死亡显著增加(P=0.326)。出血性卒中患者的血尿酸水平与美国国立卫生研究院卒中量表(NIHSS)评分(r=0.063,P=0.353)以及血尿酸水平与改良Rankin量表(mRS)评分(r=0.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecab/6607265/8a89621fb212/PAMJ-32-165-g001.jpg

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