CAJ | 학술논문

急性缺血性脑卒中患者尿酸水平与出院结局的关联研究
급성결혈성뇌졸중환자뇨산수평여출원결국적관련연구
Relationship between Uric Acid Levels in Patients with Acute Ischemic Stroke and Discharged Outcome

万方数据

现代检验医学杂志現代檢驗醫學雜誌 현대검험의학잡지
JOURNAL OF MODERN LABORATORY MEDICINE
2015年 3期 17-20 ,共4页

国钰梅%马龙%包成月%黄泽宇%李方睿%杨丽荣%白文婷%程慧%刘文波%吕利英%佟伟军%周蓦%李红美%许锬

국옥매%마룡%포성월%황택우%리방예%양려영%백문정%정혜%류문파%려리영%동위군%주맥%리홍미%허담

急性缺血性脑卒中%尿酸%出院结局急性缺血性腦卒中%尿痠%齣院結跼
급성결혈성뇌졸중%뇨산%출원결국
acute ischemic stroke%uric acid%discharged outcome

目的：探讨急性缺血性脑卒中患者入院时不同尿酸水平与出院结局的关系。方法采用回顾性队列研究的方法，连续性纳入内蒙古兴安盟人民医院2009年6月1日～2012年5月31日的全部急性缺血性脑卒中患者为研究对象，共计3440例。结局不良定义为发生残疾或住院期间死亡。残疾的定义参照（modified rankin’s scale，MRs）脑卒中量表，评分在3分及其以上者（MRs≥3）定义为残疾。采用尿酸水平的百分位数 P20，P60和 P90为界点将研究对象分为4组，危险因素的分析采用两分类非条件 logistic 回归方法，计算比值比（odds ratio，OR）及95％可信区间（95％ confident interval，95％CI）。所有检验均为双侧检验，检验水准α＝0.05。结果研究对象中发生不良结局的共359人，占10.44％。单因素 lo-gistic 回归分析显示，相对最低分位组（UA≤222.6 mmol／L），处于二，三分位组（UA 水平为222.7～310.9 mmol／L 和311.0～419.7 mmol／L）发生结局不良的 OR（95％CI）为0.70（0.53～0.91）（P ＜0.05）和0.66（0.49～0.88）（P ＜0.05）。最高分位组相对最低分位组 OR 值无统计学差异。在调整了年龄、体温、高血压、高血糖、脑卒中病史、高三酰甘油、高低密脂蛋白胆固醇和吸烟后，相对于最低分位组，依然有处于二，三分位组发生结局不良的 OR（95％CI）为0.70（0.53～0.93）（P ＜0.05）和0.66（0.48～0.90）（P ＜0.05）。最高分位组相对最低分位组 OR 值差异无统计学意义。结论急性缺血性脑卒中患者入院时较高的尿酸水平可能独立的与出院结局良好有关联。
목적：탐토급성결혈성뇌졸중환자입원시불동뇨산수평여출원결국적관계。방법채용회고성대렬연구적방법，련속성납입내몽고흥안맹인민의원2009년6월1일～2012년5월31일적전부급성결혈성뇌졸중환자위연구대상，공계3440례。결국불량정의위발생잔질혹주원기간사망。잔질적정의삼조（modified rankin’s scale，MRs）뇌졸중량표，평분재3분급기이상자（MRs≥3）정의위잔질。채용뇨산수평적백분위수 P20，P60화 P90위계점장연구대상분위4조，위험인소적분석채용량분류비조건 logistic 회귀방법，계산비치비（odds ratio，OR）급95％가신구간（95％ confident interval，95％CI）。소유검험균위쌍측검험，검험수준α＝0.05。결과연구대상중발생불량결국적공359인，점10.44％。단인소 lo-gistic 회귀분석현시，상대최저분위조（UA≤222.6 mmol／L），처우이，삼분위조（UA 수평위222.7～310.9 mmol／L 화311.0～419.7 mmol／L）발생결국불량적 OR（95％CI）위0.70（0.53～0.91）（P ＜0.05）화0.66（0.49～0.88）（P ＜0.05）。최고분위조상대최저분위조 OR 치무통계학차이。재조정료년령、체온、고혈압、고혈당、뇌졸중병사、고삼선감유、고저밀지단백담고순화흡연후，상대우최저분위조，의연유처우이，삼분위조발생결국불량적 OR（95％CI）위0.70（0.53～0.93）（P ＜0.05）화0.66（0.48～0.90）（P ＜0.05）。최고분위조상대최저분위조 OR 치차이무통계학의의。결론급성결혈성뇌졸중환자입원시교고적뇨산수평가능독립적여출원결국량호유관련。
Objective To examine the association between uric acid (UA)levels of patients with acute ischemic stroke at ad-mission and discharged outcome.Methods The acute ischemic stroke patients of Xinganmeng People’s Hospital in Inner Mongolia,from June 1,2009 to May 31,2012 were continuity included in the present study,the included analysis sample size were 3 440 cases.Poor discharged outcome was defined as the occurrence of disability or death.With reference to the Modi-fied Rankin's Scale (MRs)Stroke Scale,Scores were recorded in the questionnaires,score of 3 or more (MRs≥3)was de-fined as disability.The patients were all grouped by P20,P60,P90 of UA,binary logistic regression were used in studying of risk factors,calculated the odds ratios (Odds ratio,OR)and 95% confidence interval (95% Confident interval,95%CI).All tests were two-sided test and a significance level of 0.05.Results A total of 359 people occurred poor outcomes in the stud-y,accounting for 10.44%.Univariate logistic regression analysis of poor outcome occurred showed that relative to the lowest group(P20,UA≤222.6 mmol/L),the second and third group (UA:222.7 ~ 310.9 mmol/L and 311.0~419.7 mmol/L) OR (95% CI)were:0.70(0.53~0.91)(P <0.05)and 0.66(0.49~0.88)(P <0.05).After adjusted age,body tempera-ture,high blood pressure,hyperglycemia,history of stroke,high triglycerides,high LDL-C and smoking,relative to the low-est level group,the second and third group occurred poor outcoming OR (95% CI)were:0.70(0.53~0.93)(P <0.05)and 0.66(0.48~0.90)(P <0.05).Conclusion Higher levels of uric acid levels in patients with acute ischemic stroke may inde-pendently related with occurred poor discharged outcome.