Cheng Zicheng, Zhan Zhenxiang, Fu Yaming, Zhang Wen Yuan, Xia Lingfan, Xu Tong, Chen Hongfang, Han Zhao
Department of Neurology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, China.
Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
Curr Neurovasc Res. 2022;19(2):150-159. doi: 10.2174/1567202619666220707093427.
Uric acid (UA) has both antioxidative and pro-oxidative properties. The study aimed to investigate the relationship between serum UA and hemorrhagic transformation (HT) after intravenous thrombolysis in patients with acute ischemic stroke.
The patients undergoing intravenous thrombolysis from two hospitals in China were retrospectively analyzed. HT was evaluated using computed tomography images reviewed within 24- 36h after thrombolysis. Symptomatic intracranial hemorrhage (sICH) was defined as HT accompanied by worsening neurological function. Multivariate logistic regression and spline regression models were performed to explore the relationship between serum UA levels and the risk of HT and sICH.
Among 503 included patients, 60 (11.9%) were diagnosed with HT and 22 (4.4%) developed sICH. Patients with HT had significant lower serum UA levels than those without HT (245 [214-325 vs. 312 [256-370] μmol/L, p < 0.001). Multivariable logistic regression analysis indicated that patients with higher serum UA levels had a lower risk of HT (OR per 10-μmol/L increase 0.96, 95%CI 0.92-0.99, p = 0.015). Furthermore, multiple-adjusted spline regression models showed a Ushaped association between serum UA levels and HT (p < 0.001 for non-linearity). Similar results were present between serum UA and sICH. Restricted cubic spline models predicted the lowest risk of HT and sICH when the serum UA levels were 386μmol/L.
The data show the U-shaped relationship between serum UA levels and the risk of HT and sICH after intravenous thrombolysis.
尿酸（UA）具有抗氧化和促氧化特性。本研究旨在探讨急性缺血性脑卒中患者静脉溶栓后血清尿酸与出血性转化（HT）之间的关系。
对中国两家医院接受静脉溶栓治疗的患者进行回顾性分析。在溶栓后24 - 36小时内通过计算机断层扫描图像评估HT。症状性颅内出血（sICH）定义为伴有神经功能恶化的HT。采用多因素逻辑回归和样条回归模型探讨血清尿酸水平与HT及sICH风险之间的关系。
在纳入的503例患者中，60例（11.9%）被诊断为HT，22例（4.4%）发生sICH。HT患者的血清尿酸水平显著低于未发生HT的患者（245[214 - 325]与312[256 - 370]μmol/L，p < 0.001）。多变量逻辑回归分析表明，血清尿酸水平较高的患者发生HT的风险较低（每增加10μmol/L的OR为0.96，95%CI为0.92 - 0.99，p = 0.015）。此外，多因素调整样条回归模型显示血清尿酸水平与HT之间呈U形关联（非线性p < 0.001）。血清尿酸与sICH之间也有类似结果。受限立方样条模型预测，当血清尿酸水平为386μmol/L时，HT和sICH的风险最低。
数据显示静脉溶栓后血清尿酸水平与HT及sICH风险之间呈U形关系。
