缺血性卒中患者血清尿酸水平与TAC、MDA及临床预后的相关性

摘要

Objective To investigate the correlation of uric acid,total antioxidant capacity (TAC),malondialdehyde(MDA) and clinical prognosis in patients with ischemic stroke.Methods A total of 162 acute ischemic stroke patients were included.The general clinical data,the total antioxidant capacity,superoxide dismutase,malondialdehyde,uric acid levels were collected.At 14 days,the scores of modified Rankin Score＞2(mRS＞2) was defined as poor prognosis and mRS≤ 2 points was defined as excellent outcome.Results The history of diabetes,previous stroke or transient ischemic stroke(TIA) incidence of poor outcome group was higher than that of the good outcome group,diastolic blood pressure,uric acid,TAC,triglyceride and high density lipoprotein(HDL) level were lower than that in the good outcome group,MDA and fasting blood glucose levels are higher than good outcome group,the difference was statistically significant (P＜0.05).Logistic regression analysis showed that past stroke or TIA history,MDA was an independent risk factor for ischemic stroke,and uric acid,HDL,and TAC were prognostic factors.Uric acid level was positively correlated with TAC and prognosis,which was negatively correlated with MDA.Conclusion The patients with higher levels of uric acid level has lower level of oxidative stress,and better clinical prognosis.%目的 探讨缺血性卒中患者血清尿酸水平与总抗氧化能力(total antioxidant capacity,TAC)、丙二醛(malondialdehyde,MDA)及临床预后的相关性.方法 收集162例缺血性卒中患者的临床资料,检测血清尿酸、TAC、MDA水平.记录住院14 d时改良Rankin评分(mRS＞2分定义为预后不良,mRS≤2分为预后良好).结果 转归不良组糖尿病病史、既往卒中或短暂性脑缺血发作(transient ischemic stroke,TIA)病史发生率高于转归良好组,基线舒张压、尿酸、TAC、三酰甘油、高密度脂蛋白水平低于转归良好组,MDA和空腹血糖水平高于转归良好组,差异有统计学意义(P＜0.05).Logistic回归分析结果显示,既往卒中或TIA病史、MDA是缺血性脑卒中预后的独立危险因素;尿酸、高密度脂蛋白、TAC是预后的保护因素.相关分析结果显示,尿酸水平与TAC和预后呈正相关,与MDA呈负相关.结论 尿酸水平较高的缺血性脑卒中患者氧化应激水平较低,临床预后较好.