Liu Chih-Yang, Hsiao Cheng-Lun, Chen Pei-Ya, Tsou Adam, Tzeng I-Shiang, Lin Shinn-Kuang
Stroke Center and Department of Neurology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 23142, Taiwan.
School of Medicine, Tzu Chi University, Hualien 97004, Taiwan.
Biomedicines. 2022 Sep 4;10(9):2185. doi: 10.3390/biomedicines10092185.
(1) Background: The role of uric acid in stroke outcomes remains inconclusive. (2) Methods: We retrospectively enrolled 3370 patients with acute ischemic stroke. (3) Results: Uric acid level was higher in men than in women. Univariate analyses revealed that the rates of hyperuricemia were higher in all patients and in women for unfavorable outcomes. For death, the hyperuricemia rates were higher in all patients including men and women, and the uric acid levels were also higher in all patients and in women. A J-shaped curve was observed between uric acid and the discharge-modified Rankin Scale score. Patients within Quartiles 1 (<4.1 mg/dL) and 4 (>6.5 mg/dL) of uric acid had higher rates of unfavorable outcomes and death than patients within Quartiles 2 (4.1−5.1 mg/dL) and 3 (5.1−6.2 mg/dL). Multivariable analyses for unfavorable outcomes revealed that Quartile 1 of uric acid was a significant factor in all patients and in men. In men, a significant factor for death was being in Quartile 1 of uric acid. In women, higher levels of uric acid or hyperuricemia (>6.6 mg/dL) were significant factors for death. (4) Conclusions: Lower uric acid levels are a predictor for unfavorable outcomes and death in men, and higher uric acid levels are a predictor for death in women.
(1) 背景：尿酸在中风预后中的作用仍无定论。(2) 方法：我们回顾性纳入了3370例急性缺血性中风患者。(3) 结果：男性尿酸水平高于女性。单因素分析显示，所有患者及女性中，高尿酸血症患者出现不良预后的比例更高。对于死亡，所有患者（包括男性和女性）中高尿酸血症发生率更高，且所有患者及女性的尿酸水平也更高。尿酸与出院时改良Rankin量表评分之间呈J形曲线。尿酸处于四分位数1（<4.1mg/dL）和四分位数4（>6.5mg/dL）的患者，与处于四分位数2（4.1−5.1mg/dL）和四分位数3（5.1−6.2mg/dL）的患者相比，不良预后和死亡发生率更高。不良预后的多因素分析显示，尿酸四分位数1是所有患者及男性中的一个显著因素。在男性中，尿酸处于四分位数1是死亡的一个显著因素。在女性中，较高的尿酸水平或高尿酸血症（>6.6mg/dL）是死亡的显著因素。(4) 结论：较低的尿酸水平是男性不良预后和死亡的预测指标，而较高的尿酸水平是女性死亡的预测指标。
