Nanhua University, Hengyang, Hunan, China.
Department of Neurology, The First People's Hospital of Changde City, Changde, Hunan, China.
Biomed Res Int. 2020 Jun 22;2020:2310307. doi: 10.1155/2020/2310307. eCollection 2020.
Numerous studies have shown that uric acid (UA) is associated with cerebrovascular disease, but whether UA is a protective factor or worsens the risk of developing cerebrovascular disease remains controversial. This study investigated the relationship between UA levels detected at admission and the severity of acute primary cerebral infarction. This cross-sectional study enrolled patients with acute primary cerebral infarction ( = 238, 157 men). We designated the levels of serum UA measured at the time of admission as the independent variable and the degree of neurological impairment at admission as the dependent variable. The National Institutes of Health Stroke Scale (NIHSS) was used to assess the extent of neurological dysfunction: NIHSS ≤ 5, minor stroke; NIHSS > 5, moderate to severe stroke. There was a statistically significant difference in UA levels between patients with mild cerebral infarctions (NIHSS ≤ 5) and those with moderate or severe cerebral infarctions (NIHSS > 5) ( < 0.0001). After adjusting for confounding factors, the serum UA level was found to be nonlinearly related to NIHSS, and the inflection point was 372 mol/L. The extent of the influence and confidence interval was 0.99 (0.98, 0.99) on the left side of the inflection point and 1.00 (1.00, 1.01) on the right side. There was a nonlinear relationship between the UA level measured on admission and the degree of neurological impairment in patients with acute primary cerebral infarction. When UA was <372 mol/L, it was negatively correlated with the degree of neurological impairment in patients with acute cerebral infarction, but when UA was ≥372 mol/L, the protective effect of UA disappeared.
大量研究表明尿酸（UA）与脑血管病有关，但 UA 是保护因素还是增加脑血管病发病风险仍存在争议。本研究旨在探讨入院时 UA 水平与急性原发性脑梗死严重程度的关系。本横断面研究纳入急性原发性脑梗死患者（n=238，男 157 例）。以入院时测定的血清 UA 水平为自变量，入院时神经功能缺损程度为因变量。采用美国国立卫生研究院卒中量表（NIHSS）评估神经功能障碍程度：NIHSS≤5 分为轻度卒中，NIHSS>5 分为中重度卒中。轻度脑梗死（NIHSS≤5）和中重度脑梗死（NIHSS>5）患者的 UA 水平差异有统计学意义（<0.0001）。校正混杂因素后，UA 水平与 NIHSS 呈非线性相关，拐点为 372μmol/L。拐点左侧 UA 水平对 NIHSS 的影响程度及置信区间为 0.99（0.98，0.99），右侧为 1.00（1.00，1.01）。入院时 UA 水平与急性原发性脑梗死患者神经功能缺损程度之间存在非线性关系。入院时 UA<372μmol/L 时与急性脑梗死患者神经功能缺损程度呈负相关，而 UA≥372μmol/L 时 UA 的保护作用消失。
