中国卒中杂志
中國卒中雜誌
중국졸중잡지
CHINESE JOURNAL OF STROKE
2014年
2期
94-99
,共6页
杨得奖%谭彧%刘兴媛%陈小红%邓幼清
楊得獎%譚彧%劉興媛%陳小紅%鄧幼清
양득장%담욱%류흥원%진소홍%산유청
血尿酸%高尿酸血症%缺血性卒中%脑白质病变%危险因素
血尿痠%高尿痠血癥%缺血性卒中%腦白質病變%危險因素
혈뇨산%고뇨산혈증%결혈성졸중%뇌백질병변%위험인소
Serum uric acid%Hyperuricemia%Ischemic stroke%White matter lesions%Risk factors
目的探讨急性缺血性卒中患者血尿酸水平与脑白质病变（white matter lesions，WMLs）的相关性。方法连续入选2011年1月～2012年12月发病48 h内的首发缺血性卒中患者进行横断面研究，按照Ylikoski评分将患者分为两组：重度WMLs组、无或轻度WMLs组。比较两组患者血糖、甘油三酯（triglyceride，TG）、总胆固醇（total cholesterol，TC）、低密度脂蛋白-胆固醇（low density lipoprotein-cholesterol，LDL-C）、高密度脂蛋白-胆固醇（high density lipoprotein-cholesterol，HDL-C）及血尿酸水平，并行Logistic回归分析重度WMLs危险因素。<br> 结果共入选急性缺血性卒中患者321例，其中重度WMLs组159例，无或轻度WMLs组162例。重度WMLs组患者年龄（P＜0.001）、糖尿病发生率（P=0.011）、血糖（P＜0.001）、血尿酸水平（P＜0.001）、高尿酸血症发生率（P=0.002）均高于无或轻度WMLs组（P均＜0.05），两组性别、高血压发生率、收缩压、舒张压、心房颤动发生率、血TG、TC、LDL-C、HDL-C水平、吸烟史比例无显著差异。校正年龄、性别、血压、伴发高血压、糖尿病、心房颤动、血糖、血脂及吸烟史后，年龄[比值比（odds ratio， OR）1.062，95%可信区间（confidence interval，CI）1.0008～1.119，P=0.023]、血尿酸水平（OR 1.531，95%CI 1.186～1.975，P=0.001）和高尿酸血症（OR 1.131，95%CI 1.047～1.222，P=0.002）是急性缺血性卒中患者发生重度WMLs的独立危险因素。<br> 结论血尿酸水平和高尿酸血症是急性缺血性卒中患者伴发重度WMLs的独立危险因素。
目的探討急性缺血性卒中患者血尿痠水平與腦白質病變（white matter lesions，WMLs）的相關性。方法連續入選2011年1月～2012年12月髮病48 h內的首髮缺血性卒中患者進行橫斷麵研究，按照Ylikoski評分將患者分為兩組：重度WMLs組、無或輕度WMLs組。比較兩組患者血糖、甘油三酯（triglyceride，TG）、總膽固醇（total cholesterol，TC）、低密度脂蛋白-膽固醇（low density lipoprotein-cholesterol，LDL-C）、高密度脂蛋白-膽固醇（high density lipoprotein-cholesterol，HDL-C）及血尿痠水平，併行Logistic迴歸分析重度WMLs危險因素。<br> 結果共入選急性缺血性卒中患者321例，其中重度WMLs組159例，無或輕度WMLs組162例。重度WMLs組患者年齡（P＜0.001）、糖尿病髮生率（P=0.011）、血糖（P＜0.001）、血尿痠水平（P＜0.001）、高尿痠血癥髮生率（P=0.002）均高于無或輕度WMLs組（P均＜0.05），兩組性彆、高血壓髮生率、收縮壓、舒張壓、心房顫動髮生率、血TG、TC、LDL-C、HDL-C水平、吸煙史比例無顯著差異。校正年齡、性彆、血壓、伴髮高血壓、糖尿病、心房顫動、血糖、血脂及吸煙史後，年齡[比值比（odds ratio， OR）1.062，95%可信區間（confidence interval，CI）1.0008～1.119，P=0.023]、血尿痠水平（OR 1.531，95%CI 1.186～1.975，P=0.001）和高尿痠血癥（OR 1.131，95%CI 1.047～1.222，P=0.002）是急性缺血性卒中患者髮生重度WMLs的獨立危險因素。<br> 結論血尿痠水平和高尿痠血癥是急性缺血性卒中患者伴髮重度WMLs的獨立危險因素。
목적탐토급성결혈성졸중환자혈뇨산수평여뇌백질병변（white matter lesions，WMLs）적상관성。방법련속입선2011년1월～2012년12월발병48 h내적수발결혈성졸중환자진행횡단면연구，안조Ylikoski평분장환자분위량조：중도WMLs조、무혹경도WMLs조。비교량조환자혈당、감유삼지（triglyceride，TG）、총담고순（total cholesterol，TC）、저밀도지단백-담고순（low density lipoprotein-cholesterol，LDL-C）、고밀도지단백-담고순（high density lipoprotein-cholesterol，HDL-C）급혈뇨산수평，병행Logistic회귀분석중도WMLs위험인소。<br> 결과공입선급성결혈성졸중환자321례，기중중도WMLs조159례，무혹경도WMLs조162례。중도WMLs조환자년령（P＜0.001）、당뇨병발생솔（P=0.011）、혈당（P＜0.001）、혈뇨산수평（P＜0.001）、고뇨산혈증발생솔（P=0.002）균고우무혹경도WMLs조（P균＜0.05），량조성별、고혈압발생솔、수축압、서장압、심방전동발생솔、혈TG、TC、LDL-C、HDL-C수평、흡연사비례무현저차이。교정년령、성별、혈압、반발고혈압、당뇨병、심방전동、혈당、혈지급흡연사후，년령[비치비（odds ratio， OR）1.062，95%가신구간（confidence interval，CI）1.0008～1.119，P=0.023]、혈뇨산수평（OR 1.531，95%CI 1.186～1.975，P=0.001）화고뇨산혈증（OR 1.131，95%CI 1.047～1.222，P=0.002）시급성결혈성졸중환자발생중도WMLs적독립위험인소。<br> 결론혈뇨산수평화고뇨산혈증시급성결혈성졸중환자반발중도WMLs적독립위험인소。
Objective To investigate the relationship between serum uric acid and white matter lesions (WMLs) in cerebral ischemic stroke patients. <br> Methods From January 2011 to December 2012, a cross-sectional study was conducted at the in-patient Department of Neurology of the First Hospital of Nanchang. All consecutive patients with ifrst-episode cerebral ischemic stroke admitted to hospital within 48 hours of onset were recruited into this study. The patients were divided into severe WML group and mild WML group according to the Ylikoski scores. Serum biochemical indices including serum uric acid, serum glucose, triglyceride (TG), total cholesterol (TC), low density lipoprotein-cholesterol (LDL-C) and high density lipoprotein-cholesterol (HDL-C) were compared between the two groups, and risk factors for severe WMLs were analyzed with multivariate Logistic regression models. <br> Results Three hundred and twenty-one patients with cerebral ischemic stroke were enrolled into this study, 159 of them for severe WML group and 162 for mild WML group. The age (P<0.001), the incidence of diabetes (P=0.011), serum glucose (P<0.001), serum uric acid (P<0.001) and the incidence of hyperuricemia (P=0.002) were higher in severe WMLs group than in mild WMIs group, while the sex, the incidence of hypertension, systolic pressure, diastolic pressure, the incidence of atrial ifbrillation, TG, TC, LDL-C, HDL-C and smoking history between the two groups showed no differences (all P>0.05). Age (odds ratio [OR] 1.062, 95%conifdence interval [CI] 1.0008~1.119,P=0.023), serum uric acid (OR 1.531, 95%CI 1.186~1.975, P=0.001) and hyperuricemia (OR 1.131, 95%CI 1.047~1.222, P=0.002) were independent risk factors for severe WMLs after adjustment for sex, blood pressure, concomitant hypertension, diabetes, atrial ifbrillation, serum glucose, serum lipid and smoking history. <br> Conclusion These data suggest that serum uric acid and hyperuricemia are independent risk factors for severe WMLs in cerebral ischemic stroke patients.
