青年脑梗死患者血清尿酸水平与神经功能缺损程度的相关性研究
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摘要
目的探讨青年脑梗死患者血清尿酸(UA)水平与神经功能缺损程度的相关性。方法 2016年1月至2018年1月新诊断的青年脑梗死患者118例,依据美国国立卫生研究院卒中量表(NIHSS)评分评估神经功能缺损程度,将患者分为轻度组37例、中度组45例、重度组36例;另选取同期我院体检的健康青年志愿者30例为对照组。检测所有研究对象血清UA水平,分析血清UA水平与NIHSS评分的相关性,采用受试者工作特征(ROC)曲线分析血清UA水平预测神经功能缺损的敏感性、特异性。结果 NIHSS评分比较,对照组<轻度组<中度组<重度组,血清UA水平比较,对照组<轻度组<中度组<重度组(P <0. 05)。NIHSS评分与血清UA水平呈正相关关系(r=0. 76,P <0. 05)。血清UA水平对青年脑梗死患者神经功能缺损严重程度的预测价值良好,ROC曲线下面积为0. 76;取临界值为348μmol/L时,敏感性、灵敏性分别为83. 05%、53. 33%。结论青年脑梗死患者血清UA水平明显较正常人高,且与神经功能缺损程度显著相关,临床可加强血清UA水平监测并及时采取对症措施。
Objective To explore the correlation between serum uric acid( UA) level and degree of neurological impairment in young patients with cerebral infarction. Methods We selected 118 young patients with newly diagnosed cerebral infarction during January 2016 to January 2018. The degree of neurological impairment was evaluated by using the National Institutes of Health Stroke Scale( NIHSS).The patients were divided into mild group( n = 37),moderate group( n = 45) and severe group( n = 36).Another30 healthy young volunteers were selected as control group.The levels of serum UA in all subjects were detected,and the correlation between the serum UA level and NIHSS score was evaluated by Pearson correlation analysis.The sensitivity and specificity of the serum UA level in predicting neurological impairment were analyzed by using the receiver operating characteristic( ROC) curve analysis.Results The NIHSS score and the serum UA level showed that the control group < mild group < moderate group < severe group( P <0. 05).With the increase of NIHSS score,the serum UA level showed an increasing trend,and there was a positive correlation between the two indexes( r = 0. 76,P < 0. 05).ROC curve showed that the serum UA level had a predictive value for the severity of neurological impairment in these patients,and the area under the curve was 0. 76. When the critical value was 348 μmol/L,the sensitivity and sensitivity of serum UA for predicting the severity of neural function defection were 83. 05% and 53. 33%,respectively.Conclusion The serum UA level in young patients with cerebral infarction is significantly higher than that in normal people,and it is significantly correlated with the degree of neurological impairment.The clinical monitoring of serum UA level should be strengthened and symptomatic measures should be taken in time.
Objective To explore the correlation between serum uric acid( UA) level and degree of neurological impairment in young patients with cerebral infarction. Methods We selected 118 young patients with newly diagnosed cerebral infarction during January 2016 to January 2018. The degree of neurological impairment was evaluated by using the National Institutes of Health Stroke Scale( NIHSS).The patients were divided into mild group( n = 37),moderate group( n = 45) and severe group( n = 36).Another30 healthy young volunteers were selected as control group.The levels of serum UA in all subjects were detected,and the correlation between the serum UA level and NIHSS score was evaluated by Pearson correlation analysis.The sensitivity and specificity of the serum UA level in predicting neurological impairment were analyzed by using the receiver operating characteristic( ROC) curve analysis.Results The NIHSS score and the serum UA level showed that the control group < mild group < moderate group < severe group( P <0. 05).With the increase of NIHSS score,the serum UA level showed an increasing trend,and there was a positive correlation between the two indexes( r = 0. 76,P < 0. 05).ROC curve showed that the serum UA level had a predictive value for the severity of neurological impairment in these patients,and the area under the curve was 0. 76. When the critical value was 348 μmol/L,the sensitivity and sensitivity of serum UA for predicting the severity of neural function defection were 83. 05% and 53. 33%,respectively.Conclusion The serum UA level in young patients with cerebral infarction is significantly higher than that in normal people,and it is significantly correlated with the degree of neurological impairment.The clinical monitoring of serum UA level should be strengthened and symptomatic measures should be taken in time.
引文
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[11]宋小梅,肖燕兰.中医干预治疗对社区中心糖尿病患者血糖、血尿酸和血脂水平的影响及疗效观察[J].成都医学院学报,2016,11(6):727-730.
[12]董林菲,王峥,陈伟贤,等.急性脑梗死患者血清尿酸、超敏C反应蛋白的改变及其临床意义[J].临床神经病学杂志,2015,28(1):67-68.
[13]周汇文.不同神经功能缺损程度脑梗死病人血尿酸水平变化及其与近期预后关系分析[J].中西医结合心脑血管病杂志,2017,15(24):3212-3214.
[2]付联群,王晓丽,闵连秋,等.青年脑梗死患者病情严重程度与其危险因素及病因的关系[J].广东医学,2015,36(1):116-120.
[3]Ji R,Schwamm LH,Pervez MA,et al.Ischemic stroke and transient ischemic attack in young adults:risk factors,diagnostic yield,neuroimaging,and thrombolysis[J].JAMA Neurol,2013,70(1):51-57.
[4]中华医学会神经病学分会.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志,2015,48(4):246-257.
[5]Glymour MM,Berkman LF,Ertel KA,et al. Lesion characteristics,NIH stroke scale,and functional recovery after stroke[J]. AM Jphys Med Rehab,2007,86(9):725-733.
[6]Naess H,Kurtz M,Thomassen L,et al.Serial NIHSS scores in patients with acute cerebral infarction.[J]. Acta Neurol Scand,2016,133(6):415-420.
[7]Tsukasa S,Keisuke H,Hajime N,et al. Clinical Characteristics and Lesions Responsible for Swallowing Hesitation After Acute Cerebral Infarction:[J].Dysphagia,2016,31(4):567-573.
[8]张丽,李玮桓,刘牧,等.青年脑梗死患者血浆白蛋白及纤维蛋白原水平与其神经功能缺损严重程度的关系[J].实用医院临床杂志,2015,12(2):37-40.
[9]Xu X,Li C,Wan T,et al.Risk factors for hemorrhagic transformation following intravenous thrombolysis in acute cerebral infarction:a retrospective single center study.[J]. Neurosurgery,2017,101(19):155.
[10]张前燕,朱滨,李美清.血清尿酸及血糖水平与急性缺血性卒中病人预后的相关性分析[J].中西医结合心脑血管病杂志,2017,15(17):2199-2201.
[11]宋小梅,肖燕兰.中医干预治疗对社区中心糖尿病患者血糖、血尿酸和血脂水平的影响及疗效观察[J].成都医学院学报,2016,11(6):727-730.
[12]董林菲,王峥,陈伟贤,等.急性脑梗死患者血清尿酸、超敏C反应蛋白的改变及其临床意义[J].临床神经病学杂志,2015,28(1):67-68.
[13]周汇文.不同神经功能缺损程度脑梗死病人血尿酸水平变化及其与近期预后关系分析[J].中西医结合心脑血管病杂志,2017,15(24):3212-3214.