国际脑血管病杂志
國際腦血管病雜誌
국제뇌혈관병잡지
INTERNATIONAL JOURNAL OF CEREBROVASCULAR DISEASES
2014年
5期
392-396
,共5页
卒中%脑缺血%尿酸%高尿酸血症
卒中%腦缺血%尿痠%高尿痠血癥
졸중%뇌결혈%뇨산%고뇨산혈증
Stroke%Brain Ischemia%Uric Acid%Hyperuricemia
尿酸是嘌呤代谢的终产物.高尿酸血症定义为血尿酸> 420 μmol/L(男性)和360μmol/L(女性).多种机制可引起血尿酸水平增高.系统评价和汇总分析显示,高尿酸血症与缺血性卒中患者发病率和病死率增高均显著相关.然而,尿酸作为一种强效抗氧化剂和自由基清除剂,似乎在缺血性卒中中具有神经保护作用.早期给予尿酸可增强血栓栓塞性卒中大鼠重组组织型纤溶酶原激活剂(recombinant tissue plasminogen activator,rtPA)溶栓治疗的效果.因此,有必要对rtPA溶栓与尿酸联合应用在急性缺血性卒中患者中的临床效果进行随机对照试验.一项3期临床试验正在进行中,其结果值得期待.
尿痠是嘌呤代謝的終產物.高尿痠血癥定義為血尿痠> 420 μmol/L(男性)和360μmol/L(女性).多種機製可引起血尿痠水平增高.繫統評價和彙總分析顯示,高尿痠血癥與缺血性卒中患者髮病率和病死率增高均顯著相關.然而,尿痠作為一種彊效抗氧化劑和自由基清除劑,似乎在缺血性卒中中具有神經保護作用.早期給予尿痠可增彊血栓栓塞性卒中大鼠重組組織型纖溶酶原激活劑(recombinant tissue plasminogen activator,rtPA)溶栓治療的效果.因此,有必要對rtPA溶栓與尿痠聯閤應用在急性缺血性卒中患者中的臨床效果進行隨機對照試驗.一項3期臨床試驗正在進行中,其結果值得期待.
뇨산시표령대사적종산물.고뇨산혈증정의위혈뇨산> 420 μmol/L(남성)화360μmol/L(녀성).다충궤제가인기혈뇨산수평증고.계통평개화회총분석현시,고뇨산혈증여결혈성졸중환자발병솔화병사솔증고균현저상관.연이,뇨산작위일충강효항양화제화자유기청제제,사호재결혈성졸중중구유신경보호작용.조기급여뇨산가증강혈전전새성졸중대서중조조직형섬용매원격활제(recombinant tissue plasminogen activator,rtPA)용전치료적효과.인차,유필요대rtPA용전여뇨산연합응용재급성결혈성졸중환자중적림상효과진행수궤대조시험.일항3기림상시험정재진행중,기결과치득기대.
Uric acid is an end product of purine metabolism.Hyperuricemia is defined as serum uric acid level >420 μmol/L in man,and 360 μmol/L in woman.Several mechanisms can cause elevated serum uric acid levels.Systematic reviews and Meta-analyses have shown that hyperuricemia is significantly correlated with the increased morbidity and mortality in patients with ischemic stroke.However,as a powerful antioxidant and a radical scavenger,uric acid seems to have a neuroprotective effect in ischemic stroke.Uric acid administered early can enhance the effect of recombinant tissue plasminogen activator (rtPA) thrombolytic therapy in rats with thromboembolic stroke.Therefore,it is necessary to conduct a randomized controlled trial for the clinical effects of rtPA thrombolysis in combination with uric acid in patients with acute ischemic stroke.A phase 3 clinical trial is ongoing,and its results are worth waiting for.