The Association Of Uric Acid、Oxidative Stress And Ischemic Cerebral Stroke

Ischemic stroke is the most common type of stroke, accounting for all of the 60%~80%. With the aging of the population in our country, because of the high rate of incidence,disability and fatality of ischemic stroke,the doctors and researchers had paid many attention to it. Drug treatment mainly includes thrombolytic therapy, improving circulation, nutrition, scavenging free radicals, promoting the formation of collateral circulation, anti platelet aggregation, and so on. Even if there is a timely and effective treatment, there are still many patients with sequela. Therefore, improving the prognosis of patients with ischemic stroke has become the focus of treatment.There are many mechanisms of nerve injury after ischemic stroke occurrence, in which oxidative stress plays an important role. There is not a direct measurement to measure the level of oxidative stress,so we through measuring the changes of the markers of oxidative stress to measure the level of oxidative stress,for examples, TAC(total antioxidant capacity), SOD(superoxide dismutase) and MDA(malondialdehyde). UA(Uric acid) as one of the product of metabolism is closely related to hypertension, diabetes and other diseases. But uric acid is an important antioxidatant for human,it plays a positive antioxidant effect.But the relationship of uric acid and ischemic troke is still disputed.We want to investigate the relationship between uric acid and oxidative stress to indicate the relationship between uric acid and cerebral ischemic stroke.Objective:To illustrate the relationship between uric acid and acute ischemic stroke by the 3 sections:NO.1 The correlation of uric acid, ischemic stroke,superoxide dismutase(SOD),total antioxidant capacity and malondialdehyde(MDA); NO.2 The correlation of acute ischemic stroke neural function, superoxide dismutase(SOD),total antioxidant capacity and malondialdehyde(MDA);NO.3 The relationship of serum uric acid level and the recovery of neural function.;NO.4 The differences of superoxide dismutase(SOD),total antioxidant capacity,malondialdehyde(MDA) and uric acid(UA) between ischemic group and control group. Though we can explain the effect of uric acid on the prognosis of ischemic stroke patients is beneficial or not. It will provide a new theoretical support for the treatment of ischemic stroke.Methods:1.Study objects: The patients with ischemic stroke were collected from 2014.01~2015.07 who were treated in the NO.1 Central Hospital of Baoding. 162 cases were collected, including 82 males and 80 females, 40 to 79 years of age, average of age is(67.13+6.90) years, the median time to onset of(17.28+3.59) hours. At the same time, 160 cases of patients without ischemic stroke in the same period were collected as control group. All patients met the criteria for inclusion,and did not have any of the exclusion criteria.2.Study indexes: The general charactoristics of all cases were collected, and the level of uric acid of all of the patients were collected. We collected the 1st day abdominal venous blood 3 ml which were cryopreservated, and then measured the SOD and TAC, MDA(marker for the detection of strictly according to the instructions executed)until all the patients were collected already. At the same time, we collected the neurologic impairmentent by NIHSS(US National Institutes of Health Stroke Scale, NIHSS),and measured the nerve function at the day 14 th by mRS(modified Rankin scale and modified Rankin scale).3. Statistical processing: All statistics analyze were performed by SPSS19.0 statistical software. The normal distribution data was expressed by mean and standard deviation, the comparison between the groups used t test. The frequency data was expressed by case(%). The group comparison used chi-square test.The mean diversity was compared using variance analysis.The linear correlation analysis was used to compare the correlation. Logistic regression analysis was used to determine the independent risk factor for poor outcome, and get the odds ratio and 95% confidence intervals. P<0.05 was considered statistically significant.Results:1.Comparing the good prognosis group and poor prognosis group can find that the past history of diabetes, TIA or ischemic stroke,baseline diastolic blood pressure, the application of high density lipoprotein, fasting blood glucose, uric acid, total antioxidant capacity, superoxide dismutase, malondialdehyde, total bilirubin, direct bilirubin, indirect bilirubin and antiplatelet drugs is significantly differant(P<0.05),other’s differences had no statistical significance(P>0.05);2. The results showed that previous TIA or stroke history, baseline NIHSS score and level of malondialdehyde(MDA) was independent risk factors for poor prognosis; high density lipoprotein, uric acid, bilirubin, total antioxidant capacity, superoxide dismutase is good for outcome;3. The higher uric acid level in patients had higher total antioxidant capacity and higher levels of superoxide dismutase, while the level of MDA was lower.The difference was statistically significant(P<0.05);4. The level of uric acid patients and the content of malondialdehyde with ischemic stroke was higher than that of the normal control group, the total antioxidant capacity and superoxide dismutase level was lower than that in the normal control group, the component difference had statistical significance(P<0.05);5. Uric acid level was positively correlated with total antioxidant capacity and SOD content, which was negatively correlated with the content of MDA.Conclusion:Uric acid,as a strong antioxidant, could enhance the body’s antioxidant capacity in ischemic stroke, reduce the level of oxidative stress, and then improve the clinical prognosis of patients with ischemic stroke.