摘要
目的检测急性缺血性卒中(AIS)患者血尿酸(SUA)水平变化,并分析不同时间点SUA水平对血管性痴呆(VD)的预测价值。方法纳入2019-01—2022-08在唐山市人民医院接受治疗的AIS患者208例,完成随访195例,根据AIS 3个月后是否合并VD,将患者分为non-VD组(n=160)和VD组(n=35)。采用t检验或χ^(2)检验分析影响AIS合并VD的因素,检测患者入院时、入院24 h、入院7 d和入院14 d时患者外周血中SUA水平,Pearson相关性分析不同时段SUA水平的相关性,Logistic多因素回归分析影响AIS合并VD的独立危险因素,受试者工作特征(ROC)曲线评估不同时段血尿酸水平预测AIS合并VD的临床价值。结果脑卒中史、心房颤动、病死灶大小和入院时NIHSS评分在2组间差异有统计学意义(P<0.05)。VD组入院24 h(415.0±21.3)μmol/L、入院7 d(436.2±24.0)μmol/L和入院14 d(407.3±18.2)μmol/L时SUA水平高于non-VD组[(398.4±26.8)μmol/L、(372.1±20.7)μmol/L、(358.1±14.7)μmol/L],组间比较差异有统计学意义(P<0.05)。脑卒中史、心房颤动、大梗死病灶和入院SUA水平增加为影响AIS并发VD的危险因素。入院7 d SUA水平预测AIS并发VD的曲线下面积0.935,高于入院时和入院24 h SUA(0.763、0.786,Z=4.526、4.084,P=0.009、0.016)。结论SUA水平增加是AIS合并VD独立危险因素,入院第7天SUA水平对AIS合并VD具有较高的预测价值。
Objective To detect serum uric acid(SUA)levels in patients with acute ischemic stroke(AIS),and analyze the predictive value of SUA levels at different time points for vascular dementia(VD).Methods A total of 208 patients with AIS who were treated in Tangshan People’s Hospital from January 2019 to August 2022 were enrolled,and 195 patients were followed up.According to whether VD was complicated by AIS after 3 months,the patients were divided into non-VD group(n=160)and VD group(n=35).The factors affecting AIS complicated with VD were analyzed by t test orχ^(2) test.The serum uric acid(UA)level in peripheral blood was detected at the time of admission,24 hours,7 days and 14 days of admission.Pearson correlation was used to analyze the correlation of blood UA in different periods.Logistic multivariate regression was used to analyze independent risk factors affecting AIS with VD,receiver operating curve(ROC)was used to eveluate the clinical value of serum uric acid levels in predicting AIS with VDin different periods.Results The history of stroke,atrial fibrillation,the size of dead lesion and NIHSS score on admission were significantly different between the two groups(P<0.05).Blood UA of VD group at 24 h((415.0±21.3)μmol/L),7 d((436.2±24.0)μmol/L)and 14 d((407.3±18.2)μmol/L)were higher than non-VD group((398.4±26.8)μmol/L,(372.1±20.7)μmol/L,(358.1±14.7)μmol/L),there were significant differences between the two groups(P<0.05).History of stroke,atrial fibrillation,large infarct lesions and increased admission blood UA level were risk factors for AIS complicated by VD.The area under the curve of UA level at 7 days after admission to predict AIS complicated with VD was 0.935,which was higher than that at admission and 24 hours(0.763,0.786)(Z=4.526,4.084,P=0.009,0.016).Conclusion Increased blood UA level is an independent risk factor for AIS complicated with VD,and blood UA level on the 7th day after admission has a high predictive value for AIS complicated with VD.
作者
郝正玮
宋丽华
张秀清
孟宪静
HAO Zhengwei;SONG Lihua;ZHANG Xiuqing;MENG Xianjing(Tangshan People’s Hospital,Tangshan 063000,China)
出处
《中国实用神经疾病杂志》
2024年第3期325-329,共5页
Chinese Journal of Practical Nervous Diseases
基金
河北省医学科学研究重点课题计划项目(编号:20191597)。
关键词
急性缺血性脑卒中
血管性痴呆
血尿酸
预测价值
Acute ischemic stroke
Vascular dementia
Serum uric acid
Predictive value
