The Relation Between Hyperuricemia And Carotid Vulnerable Plaques And The Risk Of Recurrence Of The Acute Cerebral Infarction

Objective:To investigate the relationship between hyperuricemia and carotid atherosclerosis vulnerable plaque and the risk of recurrence of acute cerebral infarction(ACI).Modified ESRS will be evaluated the predictive value of risk of ACI recurrence within 1 year,and which model will be more effective.Methods:Patients of ACI were recruited in the department of neurology of the Second Affiliated Hospital of Nanchang University between February 2015 and February2016.All patients underwent CT and(or)MRI.The following data were collected:patient’s history,clinical symptoms,previous history,family history,smoking history,alcohol use,Carotid ultrasound,FPG,LDL-C,FPG and HbA1 c.Patients were periodically followed after cerebral infarction during 1-year,Cerebral infarction,death or 1-year is the endpoint.Independent risk factors of the recurrence of ACI were put into the modified ESRS(SRS1 and SRS2)to assess the value of ESRS and the modified ESRS for the prediction of ACI recurrence risk.SPSS19.0 statistical software was used to analyze the data of each group,and A probability value <0.05(2-tailed)was considered significant.Results:(1)A total of 539 cerebral infarction patients were recruited in this study.following up of.29 patients were drop out after 1 year follow-up.The cerebral infarction occurred in 70 cases,7 cases died of recurrence of cerebral infarction,4cases died of other causes(1 cases of cerebral hemorrhage,1 cases of severe pneumonia,2 cases of heart failure),a total of 77 cases were found the end point events(15%).Finally,a total of 506 cases were included in the study,351 cases of male patients,255 cases of female patients;age from 32 to 97 years old.(2)The significant differences between HUA group and normal group were in age,hypertension,smoking,ESRS score,incidence of carotid vulnerable plaque,plaque echo,recurrence of ACI.(3)Binary logistic regression model found that age,history of TIA or ACI,history of other heart disease,smoking,SUA,LDL-C,carotid artery plaque and admission hypertension have statistically significant.(4)There were significant differences between groups with or without recurrence of cerebral infarction in age,hypertension,other heart disease,previous TIA or ACI,smoking,admission hypertension,SUA,LDL-C,carotid vulnerable plaque,ESRS,SRS1 score and SRS2 score.(5)ROC curve by ESRS,SRS1 and SRS2 score in predicting the risk of recurrence of cerebral infarction were 0.715(95%CI: 0.652-0.777),0.727(95%CI:0.664-0.791),0.758(95%CI:0.697-0.820);P < 0.05 respectively,when the cut-off point were 2.5,3.5,4.5with the maximum sum of sensitivity and specificity.become of an indicator is maximum.Conclusion:(1)HUA in patients with cerebral infarction correlates with carotid vulnerable plaque and plaque echo.(2)Independent risk factors for the recurrence of cerebral infarction are age,previous TIA or ACI,previous heart disease,smoking,HUA,high LDL-C hyperlipidemia,carotid vulnerable plaque and admission hypertension.(3)The ESRS score could predict the risk of cerebral infarction recurrence,moreover,the prediction value of the recurrence of cerebral infarction would be improved if adding variables HUA,high LDL-C hyperlipidemia,admission hypertension and carotid vulnerable plaque into ESRS,however,the conclusion is worthy of further clinical evaluation.