Effect of serum uric acid on short-term outcome in ischemic stroke patients treated w ith intravenous recombinant tissue plasminogen activator / 国际脑血管病杂志

ABSTRACT

ObjectiveToinvestigatetheeffectofserumuricacid(SUA)levelonshort-term outcomes of recombinant tissue plasminogen activator (rtPA) for intravenous thrombolysis in patients w ith ischemic stroke. Methods The patients w ith acute ischemic stroke treated w ith intravenous rtPA thrombolysis w ere enrol ed. The demographic data, clinical data, and laboratory parameters w ere compared and analyzed according to the modified Rankin scale (mRS) scores at discharge. A good outcome was defined as a 3-month mRS score of 0 in patients w ith a baseline National Institute of Health Stroke Scale (NIHSS) score≤7, a score of 0–1 in those w ith a baseline NIHSS score of 8-14, and a score of 0–2 in those w ith a baseline NIHSS score ≥ 15. Results A total of 108 patients w ith acute ischemic stroke treated w ith intravenous rtPA thrombolysis w ere enrol ed. There w ere 66 patients (61.11%) in the good outcome group and 42 (38.89%) in the poor outcome group. The constituent ratios of age (62.21 ±10.25 years vs. 57.83 ±10.457 years; t=2.138, P=0.035), the baseline NIHSS scores (median and interquartile range, 10 [8-12] vs.4 [3-7]; Z=5.537, P<0.001), type 2 diabetes mel itus (40.48%vs.12.12%; χ2 =11.600, P=0.001), and previous history of stroke (9.52%vs.9.09%;χ2 =4.366, P=0.037) of the poor outcome group w ere significantly higher than those of the good outcome group, w hile the SUA level (323.119 ±87.869 mmol/L vs.385.961 ±76.166 mmol/L; t=3.936, P<0.001) w as significantly low er than that of the good outcome group. Multivariate logistic regression analysis show ed that the previous history of diabetes melitus type 2 (odds ratio [OR] 5.471, 95%confidence interval [CI] 1.472-20.334;P=0.011) and higher baseline NIHSS score (OR 1.306, 95%CI 1.147-1.486; P<0.001) were the independent risk factor for short-term clinical outcomes, w hile higher SUV level ( OR 0.992, 95%CI 0.986-0.998; P=0.015) w as an independent protective factor for poor short-term outcome. Conclusions The increased SUA level is an independent protective factor for good short-term outcome in patients treated w ith intravenous rtPA.