脑卒中高危人群血清尿酸水平与颈动脉粥样硬化易损斑块的关系:一项横断面调查

摘要

Objective To investigate the relationship between serum uric acid (UA) level and vulnerable plaque of carotid atherosclerosis (carotid atherosclerosis) in patients with high risks of stroke.Methods A cross-sectional survey was conducted in Dongying city from September 2012 to January 2013.A total of 6331 patients with high risks of stroke was screened by questionnaire,physical examination,laboratory examination and neck ultrasound.According to three percentiles of uric acid level 6331 patients with high risks of stroke were divided into three groups,and according to the detection rate and the stability of carotid plaque 6331 patients with high risks of stroke were divided into vulnerable carotid artery plaque group(n =3187),stable carotid artery plaque group (n =913)and non carotid artery plaque group (n =2240).Results There were statistically significant differences in the men,an array of smoking and drinking,family history of stroke,diabetes,age,BMI,and FBP,LDL-C,TC,TG,SBP among 3 three percentile groups of uric acid level (P＜0.05).Compared with stable carotid artery plaque group and non carotid artery plaque group,The age,FBG,TG,homocysteine(Hcy),and UA level significantly increased in vulnerable carotid artery plaque group (P＜0.05).Multivariable logistic regression analysis revealed that carotid artery plaque formation risks of the second and third quantile groups were 1.231 times (P＜0.01) and 1.658 times (P＜0.01) of the first quantile group respectively.Conclusion The serum UA level increase was associated with the occurrence of vulnerable plaque of CAS in high-risk stroke population.When UA level was 325.24 mol/L,the risk of vulnerable plaque formation was significantly higher.%目的 探讨脑卒中高危人群血清尿酸水平与颈动脉粥样硬化(carotid atherosclerosis,CAS)易损斑块的关系.方法 2012年9月～2013年1月通过横断面调查,对东营市居民通过问卷调查、体格检查、实验室检查及颈部超声检查筛选脑卒中高危人群6331例.按照尿酸水平的三分位数将脑卒中高危人群分成3组,并且根据颈动脉斑块的检出率以及稳定性来将脑卒中高危人群分为无颈动脉斑块组(n=2240)、稳定颈动脉斑块组(n=913)、易损颈动脉斑块组(n=3187).结果 依尿酸水平的三分位数分为3个组,3组男性、吸烟史、饮酒史、脑卒中家族史、糖尿病史构成比及年龄、体质量指数(BMI)、空腹血糖(FBP)、低密度脂蛋白脂蛋白(LDL-C)、总胆固醇(TC)、三酰甘油(TG)水平、收缩压(SBP)均有明显差异(P均＜0.05).与颈动脉斑块组和无颈动脉斑块组比较,易损颈动脉斑块组年龄、FBP、TG、同型半胱氨酸(Hcy)、尿酸水平均明显升高(P＜0.05).多元logistic回归分析显示,第二及第三分位组颈动脉易损斑块形成风险分别是第一分位组的1.231倍(P＜0.01)和1.658倍(P＜0.01).结论 在脑卒中高危人群中血尿酸水平升高与CAS易损斑块发生独立相关.当尿酸水平＞325.24μmol/L时易损斑块形成风险明显增高.