Correlation Between Serum Uric Acid And Prognosis In Patients With Acute Ischemic Stroke

PurposeTo observe the correlation between serum uric acid level and neurologic deficiency in admission,or daily living ability at the seventh day and one month,or mortality among patients with acute ischemic stroke.To provide scientific evidence for prevention and treatment for the acute stroke patients.MethodsPatients with acute ischemic stroke admitted to the department of neurology,the First Affiliated Hospital of Soochow University from June 2016 to August 2018 were selected in the present study.These patients were in compliance with the diagnostic criteria for the acute ischemic stroke guideline 2014 and were within 7 days of onset.Collect the patients'gender,age,smoking history,drinking history,history of hypertension,history of diabetes,history of dyslipidemia,history of atrial fibrillation,history of gout,history of hyperuricemia,blood pressure,uric acid,glucose,glycosylated hemoglobin,creatinine,triglycerides,total cholesterol,high-density lipoprotein and low-density lipoprotein.To compare the demographic information and clinical features of male and female patients.The level of uric acid was categorized into sex-specific quartiles.The NIHSS score was used to evaluate the neurologic deficiency of patients at admission.The mRS score was used to evaluated the ability of daily living at the seventh day of onset and one month.When mRs score greater than or equal to 3 was defined as a poor ADL.We also recorded the number of cases of death.Statistical analysis was performed to compare the relationship between uric acid level and neurologic deficiency,or daily living ability,also the mortality.All statistical analyses were performed using SPSS25.0 software.Results1.The study included 501 patients with acute ischemic stroke,248 male and 253 female.Smoking,alcohol consumption,dyslipidemia,incidence of gout and diastolic blood pressure,uric acid,triglyceride and creatinine in male patients were significantly higher than those of female patients,p<0.05;and age,atrial fibrillation,hyperuricemia,CE incidence,glycosylated hemoglobin,high density lipoprotein,NIHSS score at admission,the incidence of poor daily living ability at seventh day of onset and one month were significantly lower than those of female patients,p<0.05.2.Neurologic deficiency:In male patients,there was no statistically significant difference between the groups of NIHSS scores at admission,p=0.10.In female patients,the difference between the groups of NIHSS scores was statistically significant at admission,and P<0.05,from the first sub-group to the forth,there was a downward trend and then an upward trend.3.Activities of daily living:In male patients,the difference of the incidence of poor daily living ability between groups at the seventh day after onset is statistically significant,P<0.05,from the first sub-group to the forth,there was a downward trend and then an upward trend.In female patients,the difference of the incidence of poor daily living ability between groups at the seventh day after onset is statistically significant,P<0.05,from the first sub-group to the forth,there was a downward trend and then an upward trend.There was no statistically significant difference between the groups at one month of all the patients,P>0.05.4.Multivariate analysis:Adjusted age,smoking,alcohol consumption,stroke type,blood pressure,glucose,creatinine,triglycerides,total cholesterol,low density lipoprotein,high density lipoprotein and other confounding factors.With the third sub-group as the reference,in male patients at the seventh day after onset,the first sub-group and the fourth sub-group are risk factors for the occurrence of poor daily living ability,P<0.05.When a male patient at one month,the first sub-group is the risk factor for the occurrence of poor daily living ability,P<0.05.With the third sub-group as the reference,in female patients at the seventh day after onset,the first sub-group is the risk factor for the occurrence of poor daily living ability,P<0.05.When a woman at one month,the first sub-group is the risk factor for the occurrence of poor daily living ability,P<0.05.5.Mortality:Among male patients,there was no statistically significant differences in mortality among the groups,p=0.41.In female patients,the mortality rate in the fourth group was significantly higher than other groups,P<0.05.ConclusionsAmong patients with acute ischemic stroke,the effect of uric acid level on the severity and prognosis of stroke is similar in male and female patients.The elevated level of uric acid may have a neuroprotective effect.Low and high levels of serum uric acid are risk factors for poor daily living ability after stroke.High levels of serum uric acid may be a risk factor for increased risk of death.