摘要
目的探讨高尿酸血症与脑梗死的关系,为预防脑梗死寻求新的途径。方法随机抽取已确诊为脑梗死的新发病例的住院患者200例做为病例组,并抽取同期来我院行健康体检者200例为对照组,两组的性别和年龄相匹配。调查内容包括:人口统计学、病史、血尿酸、血压、血脂、血糖、脑梗死病例基线神经功能评分(依据中国脑卒中临床神经功能缺损评分标准分为轻型0～15分、中型16～30分、重型31～45分)和梗死面积(梗死区直径>50mm为大面积梗死,梗死区直径<20mm为小面积梗死,介于两者之间为中等面积梗死)等。对两组间高尿酸血症的阳性率、血尿酸平均水平进行比较,对血尿酸水平与脑梗死病情及梗死面积之间的相关性进行分析。结果病例组高尿酸血症阳性率(24.5%)明显高于对照组(8%),差别有显著的统计学意义(P=0.001,χ2=15.946,OR=3.09,95%CI=1.76～5.24),尤其对女性差别更显著(P=0.001,χ2=13.91,OR=6.3,95%CI=2.38～16.71)。采用多因素分析(Logistic回归分析),修正其它已确定的脑血管病危险因素(如高血压、糖尿病、高血脂症等)后,这种关联依然存在(P=0.006,χ2=15.946,OR=3.06,95%CI=1.63～5.94)。脑梗死患者的血尿酸平均水平(336.96μmol/L)明显高于对照组(276.11μmol/L)(P=0.0297)。血尿酸水平与脑梗死面积呈正相关(P=0.001)。结论高尿酸血症可能是脑梗死的重要危险因素之一,且血尿酸水平越高,脑梗死面积越大,病情越重。
Objective To study the association between hyperuricemia and cerebral infarction and look for the new path for the prevention that the cerebral infarction. Methods Random selection 200 inpatients cases of cerebral infarction newly diagnosed and 200 controls without cerebral infarction inpatients with same age and in same sex were cecruited as control group. Data were collected with regards to patient demography,medical history,blood uric acid,blood pressure,blood fat,blood sugar,baseline neurological score for cerebral infarction （mild/moderate/severe CCNISS scire 0~15/16~30/31~45） and final infarction size on CT/MRI（minor/moderate/major diameter of infarction focus20 mm/21~50 mm/50 mm）. Compare incidence of hyperuricemia and mean of blood uric acid in the two groups. Analysis the relationship between blood concentration of uric acid with neurological severity of cerebral infarction and size of the infarction. Results The incidence of hyperuricemia was significantly higher in case group （24.5%） than in control group （8%）,the difference was significant （P=0.001,χ2=15.946,OR=3.09,95% CI=1.76~5.24）,especially in women （P=0.001,χ2=13.91,OR=6.3,95% CI=2.38~16.71）.In multivariate analysis （logistic regression）,this relationship held true even after correction for the presence of established cerebrovascular risk factors （such as hypertension,diabetes mellitus,and hyperlipidemia）（P=0.006,χ2=15.946,OR=3.06,95%CI=1.63~5.94）.Median urate level in patients with cerebral infarction （336.96 μmol/L） was significantly higher than that in the control group （276.11 μmol/L）（P=0.0297）. The severity of neurological impairmet and the infarction size in patients with cerebral infarction have been found positive correlation related to the concentration of uric acid （P=0.001）. Conclusion Results showed that Hyperuricemia possible mihgt be among risk of cerebral infarction. The more elevated the uric acid are,the more big size of the infaction,the more severe pathogenetic condition to cerebral infarction.
出处
《黑龙江医学》
2010年第3期173-176,共4页
Heilongjiang Medical Journal
关键词
高尿酸血症
脑梗死
对照
Hyperuricemia cerebral infarction
Case-control study
