短暂性脑缺血发作不同持续时间患者血清尿酸水平差异的研究
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摘要
目的本研究探究短暂性脑缺血发作(TIA)不同持续时间患者血清尿酸水平的差异。方法收集2017年2～7月在哈尔滨医科大学附属第一医院(我院)神经内科住院治疗的346例TIA患者,按照症状持续时间分为:<10 min组、10～19 min组、20～59 min组和≥60 min组。另选择我院体检中心行常规体格检查的62例健康者为对照组。对各组研究对象的基线数据、高危因素、辅助检查指标等进行统计学分析。结果高血压病、高脂血症、脑卒中及冠心病病史为TIA高危因素,TIA不同持续时间组上述疾病与对照组比较患病率高(P <0. 05)。TIA不同持续时间组与对照组比较,白细胞计数、中性粒细胞计数、中性粒细胞百分比和中性粒细胞与淋巴细胞比值等炎症指标均差异无统计学意义(P>0. 05)。TIA 20～59 min组和≥60 min组与对照组比较,血清尿酸水平升高(P <0. 05);<10 min组和10～19 min组与对照组比较,血清尿酸水平有升高趋势,但差异无显著性(P> 0. 05)。结论 TIA持续时间≥20 min患者的血清尿酸水平显著升高,提示尿酸可能在TIA的发生、发展过程中起一定作用。
Aim To explore whether there is a difference in serum uric acid levels among patients with transient ischemic attack of different duration. Methods 346 patients with transient ischemic attack( TIA) who were hospitalized in the department of neurology,the First Affiliated Hospital of Harbin Medical University from February 2017 to July 2017 were enrolled. They were divided into 4 groups according to the duration of symptoms: a less than 10 min group,a 10 ～ 19 min group,a 20 ～ 59 min group and a more than or equal to 60 min group. Results Hypertension,hyperlipidemia,stroke and coronary artery disease are risk factors of TIA. Compared with the control group,the prevalence of these diseases were higher in different TIA duration groups( P < 0. 05). White blood cell count,neutrophil count,neutrophil percentage and neutrophil lymphocyte ratio were common indicators of inflammation in clinical practice. Compared with the control group,there was no significant difference in these indicators in different TIA duration groups( P > 0. 05). Compared with the control group,the level of serum uric acid increased in20 ～ 59 min duration group and greater than or equal to 60 min duration group( P < 0. 05). However,compared with the control group,there was no significant difference in the serum uric acid level in groups with shorter duration( less than 10 min and 10 ～ 19 min)( P > 0. 05),but there was an increasing trend.Conclusion The serum uric acid level of patients with TIA duration more than or equal to 20 min increased significantly,suggesting that uric acid may play a role in the occurrence and development of TIA.
Aim To explore whether there is a difference in serum uric acid levels among patients with transient ischemic attack of different duration. Methods 346 patients with transient ischemic attack( TIA) who were hospitalized in the department of neurology,the First Affiliated Hospital of Harbin Medical University from February 2017 to July 2017 were enrolled. They were divided into 4 groups according to the duration of symptoms: a less than 10 min group,a 10 ～ 19 min group,a 20 ～ 59 min group and a more than or equal to 60 min group. Results Hypertension,hyperlipidemia,stroke and coronary artery disease are risk factors of TIA. Compared with the control group,the prevalence of these diseases were higher in different TIA duration groups( P < 0. 05). White blood cell count,neutrophil count,neutrophil percentage and neutrophil lymphocyte ratio were common indicators of inflammation in clinical practice. Compared with the control group,there was no significant difference in these indicators in different TIA duration groups( P > 0. 05). Compared with the control group,the level of serum uric acid increased in20 ～ 59 min duration group and greater than or equal to 60 min duration group( P < 0. 05). However,compared with the control group,there was no significant difference in the serum uric acid level in groups with shorter duration( less than 10 min and 10 ～ 19 min)( P > 0. 05),but there was an increasing trend.Conclusion The serum uric acid level of patients with TIA duration more than or equal to 20 min increased significantly,suggesting that uric acid may play a role in the occurrence and development of TIA.
引文
[1]Wang Y,Zhao X,Jiang Y,et al.Prevalence,knowledge,and treatment of transient ischemic attacks in China[J].Neurology,2015,84:2354-2361
[2]方卫纲,黄晓明,王玉,等.高尿酸血症在北京地区1997人中的患病情况及相关因素分析[J].中华医学杂志,2006,86:1764-1768
[3]Wu J,Qiu L,Cheng XQ,et al.Hyperuricemia and clustering of cardiovascular risk factors in the Chinese adult population[J].Sci Rep,2017,7:5456
[4]季燕.低密度脂蛋白胆固醇、尿酸与TIA发作的相关性分析[J].世界临床医学,2016,10:3-4
[5]Easton JD,Saver JL,Albers GW,et al.Definition and evaluation of transient ischemic attack:a scientific statement for healthcare professionals from the American Heart Association/American Stroke Association Stroke Council;Council on Cardiovascular Surgery and Anesthesia;Council on Cardiovascular Radiology and Intervention;Council on Cardiovascular Nursing;and the Interdisciplinary Council on Peripheral Vascular Disease.The American Academy of Neurology affirms the value of this statement as an educational tool for neurologists[J].Stroke,2009,40:2276-2293
[6]许桂芬,郑勇,杨巍.尿酸、NT-proBNP及hs CRP在慢性心力衰竭诊断中的临床价值[J].海峡药学,2016,28:92-94
[7]赵兴军,刘芳,孟颖,等.短暂性脑缺血发作患者血浆高半胱氨酸与尿酸水平相关性研究[J].中国卒中杂志,2017,12:786-789
[8]秋爽,栾松,戴悦.中青年短暂性脑缺血发作患者临床特征分析[J].中国实用内科杂志,2008,28:481-482
[9]Tanaka T,Milaneschi Y,Zhang Y,et al.A double blind placebo controlled randomized trial of the effect of acute uric acid changes on inflammatory markers in humans:A pilot study[J].PLo S One,2017,12:e0181100
[10]Takir M,Kostek O,Ozkok A,et al.Lowering Uric Acid With Allopurinol Improves Insulin Resistance and Systemic Inflammation in Asymptomatic Hyperuricemia[J].J Investig Med,2015,63:924-929
[11]Ogˇuz N,Kr9a M,etin A,et al.Effect of uric acid on inflammatory COX-2 and ROS pathways in vascular smooth muscle cells[J].J Recept Signal Transduct Res,2017,37:500-505
[12]Spiga R,Marini MA,Mancuso E,et al.Uric Acid Is Associated With Inflammatory Biomarkers and Induces Inflammation Via Activating the NF-κB Signaling Pathway in Hep G2 Cells[J].Arterioscler Thromb Vasc Biol,2017,37:1241-1249
[13]Ryu HM,Kim YJ,Oh EJ,et al.Hypoxanthine induces cholesterol accumulation and incites atherosclerosis in apolipoprotein E-deficient mice and cells[J].J Cell Mol Med,2016,20:2160-2172
[14]Neogi T,Ellison RC,Hunt S,et al.Serum uric acid is associated with carotid plaques:the National Heart,Lung,and Blood Institute Family Heart Study[J].J Rheumatol,2009,36:378-384
[15]张霞,曹勇军,季萍,等.经颅多普勒检测秦山核电站工作者颅内各血管参数的分析[J].中国临床神经科学,2009,17:407-411
[16]是明启,王玉洲,宋朝功.短暂性脑缺血发作与脑动脉狭窄的关系[J].中国临床神经科学,2008,16:302-303
[2]方卫纲,黄晓明,王玉,等.高尿酸血症在北京地区1997人中的患病情况及相关因素分析[J].中华医学杂志,2006,86:1764-1768
[3]Wu J,Qiu L,Cheng XQ,et al.Hyperuricemia and clustering of cardiovascular risk factors in the Chinese adult population[J].Sci Rep,2017,7:5456
[4]季燕.低密度脂蛋白胆固醇、尿酸与TIA发作的相关性分析[J].世界临床医学,2016,10:3-4
[5]Easton JD,Saver JL,Albers GW,et al.Definition and evaluation of transient ischemic attack:a scientific statement for healthcare professionals from the American Heart Association/American Stroke Association Stroke Council;Council on Cardiovascular Surgery and Anesthesia;Council on Cardiovascular Radiology and Intervention;Council on Cardiovascular Nursing;and the Interdisciplinary Council on Peripheral Vascular Disease.The American Academy of Neurology affirms the value of this statement as an educational tool for neurologists[J].Stroke,2009,40:2276-2293
[6]许桂芬,郑勇,杨巍.尿酸、NT-proBNP及hs CRP在慢性心力衰竭诊断中的临床价值[J].海峡药学,2016,28:92-94
[7]赵兴军,刘芳,孟颖,等.短暂性脑缺血发作患者血浆高半胱氨酸与尿酸水平相关性研究[J].中国卒中杂志,2017,12:786-789
[8]秋爽,栾松,戴悦.中青年短暂性脑缺血发作患者临床特征分析[J].中国实用内科杂志,2008,28:481-482
[9]Tanaka T,Milaneschi Y,Zhang Y,et al.A double blind placebo controlled randomized trial of the effect of acute uric acid changes on inflammatory markers in humans:A pilot study[J].PLo S One,2017,12:e0181100
[10]Takir M,Kostek O,Ozkok A,et al.Lowering Uric Acid With Allopurinol Improves Insulin Resistance and Systemic Inflammation in Asymptomatic Hyperuricemia[J].J Investig Med,2015,63:924-929
[11]Ogˇuz N,Kr9a M,etin A,et al.Effect of uric acid on inflammatory COX-2 and ROS pathways in vascular smooth muscle cells[J].J Recept Signal Transduct Res,2017,37:500-505
[12]Spiga R,Marini MA,Mancuso E,et al.Uric Acid Is Associated With Inflammatory Biomarkers and Induces Inflammation Via Activating the NF-κB Signaling Pathway in Hep G2 Cells[J].Arterioscler Thromb Vasc Biol,2017,37:1241-1249
[13]Ryu HM,Kim YJ,Oh EJ,et al.Hypoxanthine induces cholesterol accumulation and incites atherosclerosis in apolipoprotein E-deficient mice and cells[J].J Cell Mol Med,2016,20:2160-2172
[14]Neogi T,Ellison RC,Hunt S,et al.Serum uric acid is associated with carotid plaques:the National Heart,Lung,and Blood Institute Family Heart Study[J].J Rheumatol,2009,36:378-384
[15]张霞,曹勇军,季萍,等.经颅多普勒检测秦山核电站工作者颅内各血管参数的分析[J].中国临床神经科学,2009,17:407-411
[16]是明启,王玉洲,宋朝功.短暂性脑缺血发作与脑动脉狭窄的关系[J].中国临床神经科学,2008,16:302-303