From the Department of Anesthesiology (He, Zheng, Wu), Department of Neurosurgery (Liu), Department of Neurology (Wu), Department of Critical Care Medicine (Xue), West China Hospital of Sichuan University, Sichuan, China.
Neurosciences (Riyadh). 2021 Jan;26(1):36-44. doi: 10.17712/nsj.2021.1.20200089.
To investigate changes in sUA in patients with TBI or patients after cerebral tumor surgery and the possible mechanism of these changes.
This prospective cohort study enrolled patients with TBI or underwent cerebral tumor surgery at West China Hospital, China, from November 2014 to May 2018. Serum UA (sUA) levels, urine excretion, UA oxidant product allantoin and other clinical parameters were assessed.
100 patients were enrolled for analysis. sUA in patients with TBI or underwent cerebral tumor surgery started to decline from day 1 after injury or surgery compared to control. This decreasing trend continued from day 3 (143.2±59.3 μmol/L, 188.8±49.4 μmol/L vs 287.3±80.2 μmol/L, <0.0001) until day 7. No difference in urinary UA excretion was found in the TBI group or cerebral tumor surgery group. Urine allantoin and the allantoin to sUA ratio of the TBI group decreased on day 3 compared with the control group. The structural equation model showed that the sUA level was related to the Glasgow coma score (GCS) (r=0.5383, <0.0001), suggesting the potential association of UA with consciousness level, as well as serum protein and electrolytes including albumin, calcium and phosphate.
The sUA was decreased in patients with TBI or underwent cerebral tumor surgery.
研究颅脑损伤（TBI）或脑肿瘤手术后患者血清尿酸（sUA）的变化及其可能的机制。
本前瞻性队列研究纳入了 2014 年 11 月至 2018 年 5 月期间在中国华西医院接受 TBI 或脑肿瘤手术的患者。评估了血清 UA（sUA）水平、尿排泄、UA 氧化物尿囊素及其他临床参数。
共纳入 100 例患者进行分析。与对照组相比，TBI 或脑肿瘤手术后患者的 sUA 从损伤或手术后第 1 天开始下降。这种下降趋势持续到第 3 天（143.2±59.3 μmol/L，188.8±49.4 μmol/L 比 287.3±80.2 μmol/L，<0.0001），直到第 7 天。TBI 组或脑肿瘤手术组的尿 UA 排泄无差异。与对照组相比，TBI 组的尿囊素和尿囊素与 sUA 的比值在第 3 天下降。结构方程模型显示，sUA 水平与格拉斯哥昏迷评分（GCS）相关（r=0.5383，<0.0001），提示 UA 与意识水平以及血清蛋白和电解质（包括白蛋白、钙和磷）有关。
TBI 或脑肿瘤手术后患者的 sUA 降低。
