血清尿酸水平对无神经症状颈动脉粥样硬化患者长期预后的影响研究

发布时间：2018-03-19 04:34

本文选题：颈动脉粥样硬化　切入点：颈动脉　出处：《中国全科医学》2017年30期 　论文类型：期刊论文

【摘要】：目的探讨血清尿酸水平预测无神经症状颈动脉粥样硬化患者长期预后的意义。方法收集2012年12月—2015年12月沧州市中心医院收治的656例无神经症状颈动脉粥样硬化患者的临床资料。依据患者血清尿酸水平四分位数间距将其分为75%组(n=161)、51%~75%组(n=167)、25%~50%组(n=163)、25%组(n=165)。回顾性分析患者的性别、年龄、体质指数(BMI)、合并症(高血压、糖尿病、高脂血症)、吸烟情况、生化指标[血清尿酸、同型半胱氨酸(Hcy)水平]、主要终点事件(全因死亡)、次要终点事件(心脑血管疾病致死),观察时间截至2015-12-31。结果 4组患者性别、高血压发生率、高脂血症发生率、吸烟率、血清尿酸水平、Hcy水平比较,差异有统计学意义(P0.05)。4组患者全因死亡率、心脑血管疾病致死率比较,差异有统计学意义(P0.05);Spearman秩相关分析结果显示,血清尿酸水平与无神经症状颈动脉粥样硬化患者全因死亡率、心脑血管疾病致死率呈正相关(rs值分别为0.183、0.099,P值分别为0.001、0.002)。截至观察终点,共出现全因死亡患者170例,心脑血管疾病致死患者109例。4组患者全因死亡的生存曲线、心脑血管疾病致死的生存曲线比较,差异有统计学意义(χ~2值分别为36.100、16.898,P值分别为0.001、0.001)。Cox比例风险回归模型分析结果显示,血清尿酸水平是无症状颈动脉粥样硬化患者全因死亡[RR=1.023,95%CI(1.018,1.028)]以及心脑血管疾病致死[RR=1.011,95%CI(1.008,1.014)]的独立影响因素(P0.05)。结论血清尿酸水平与无神经症状颈动脉粥样硬化患者全因死亡率以及心脑血管疾病致死率密切相关,且高血清尿酸水平提示患者预后不良。
[Abstract]:Objective to investigate the significance of serum uric acid level in predicting the long-term prognosis of patients with non-neurotic carotid atherosclerosis. Methods 656 patients with non-neurotic carotid atherosclerosis admitted to Cangzhou Central Hospital from December 2012 to December 2015 were collected. Clinical data of patients. According to the quartile spacing of serum uric acid level, the patients were divided into 75% groups, which were divided into 75% groups. The sex of the patients was analyzed retrospectively. Age, body mass index (BMI), complications (hypertension, diabetes, hyperlipidemia, smoking, biochemical index [serum uric acid], Hcy level], main end point events (all cause of death, secondary end point events (cardio-cerebrovascular disease death), observation time up to 2015-12-31. Results Sex, hypertension, hyperlipidemia, smoking rate, 4 groups of patients, The difference of serum uric acid level and Hcy level was statistically significant. There were significant differences in total cause mortality and mortality caused by cardiovascular and cerebrovascular diseases in patients with P0.054.The difference was statistically significant (P 0.05) and Spearman rank correlation analysis showed that there was no significant difference between the two groups. The serum uric acid level was positively correlated with the all-cause mortality of patients with non-neurotic carotid atherosclerosis, and the mortality rate of cardiovascular and cerebrovascular diseases was 0.183 卤0.099 (P = 0.001 卤0.002), respectively. At the end of the observation, 170 cases of all-cause death were found. The survival curve of all causes of death in 109 patients with cardiovascular and cerebrovascular diseases and the survival curve of cardio-cerebrovascular disease were significantly different (蠂 ~ 2 = 36.100 ~ 16.898 P = 0.001 / 0. 001). Cox proportional risk regression model showed that there was no significant difference between the two groups (蠂 ~ 2 = 36.100, P = 16.898, P = 0.001, P = 0.001, P = 0.001, P < 0.05). Serum uric acid level is an independent factor of death in asymptomatic carotid atherosclerosis patients [RRN 1.02395% CI 1.018 卤1.028] and cardiovascular and cerebrovascular diseases (RRRN 1.01195% CI1.0081.014). Conclusion Serum uric acid level and death of patients with non-neurotic carotid atherosclerosis are all due to death (P 0.05). The mortality rate of cardiovascular and cerebrovascular diseases is closely related to the mortality rate. High serum uric acid level suggested poor prognosis.
【作者单位】：河北省沧州市中心医院神经内三科;河北省沧州市中心医院老年病房;
【基金】：沧州市科技计划项目(151302138)
【分类号】：R543.4

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