本文選題：頸動(dòng)脈粥樣硬化　切入點(diǎn)：頸動(dòng)脈　出處：《中國(guó)全科醫(yī)學(xué)》2017年30期 　論文類(lèi)型：期刊論文

【摘要】：目的探討血清尿酸水平預(yù)測(cè)無(wú)神經(jīng)癥狀頸動(dòng)脈粥樣硬化患者長(zhǎng)期預(yù)后的意義。方法收集2012年12月—2015年12月滄州市中心醫(yī)院收治的656例無(wú)神經(jīng)癥狀頸動(dòng)脈粥樣硬化患者的臨床資料。依據(jù)患者血清尿酸水平四分位數(shù)間距將其分為75%組(n=161)、51%~75%組(n=167)、25%~50%組(n=163)、25%組(n=165)�；仡櫺苑治龌颊叩男詣e、年齡、體質(zhì)指數(shù)(BMI)、合并癥(高血壓、糖尿病、高脂血癥)、吸煙情況、生化指標(biāo)[血清尿酸、同型半胱氨酸(Hcy)水平]、主要終點(diǎn)事件(全因死亡)、次要終點(diǎn)事件(心腦血管疾病致死),觀察時(shí)間截至2015-12-31。結(jié)果 4組患者性別、高血壓發(fā)生率、高脂血癥發(fā)生率、吸煙率、血清尿酸水平、Hcy水平比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。4組患者全因死亡率、心腦血管疾病致死率比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05);Spearman秩相關(guān)分析結(jié)果顯示,血清尿酸水平與無(wú)神經(jīng)癥狀頸動(dòng)脈粥樣硬化患者全因死亡率、心腦血管疾病致死率呈正相關(guān)(rs值分別為0.183、0.099,P值分別為0.001、0.002)。截至觀察終點(diǎn),共出現(xiàn)全因死亡患者170例,心腦血管疾病致死患者109例。4組患者全因死亡的生存曲線、心腦血管疾病致死的生存曲線比較,差異有統(tǒng)計(jì)學(xué)意義(χ~2值分別為36.100、16.898,P值分別為0.001、0.001)。Cox比例風(fēng)險(xiǎn)回歸模型分析結(jié)果顯示,血清尿酸水平是無(wú)癥狀頸動(dòng)脈粥樣硬化患者全因死亡[RR=1.023,95%CI(1.018,1.028)]以及心腦血管疾病致死[RR=1.011,95%CI(1.008,1.014)]的獨(dú)立影響因素(P0.05)。結(jié)論血清尿酸水平與無(wú)神經(jīng)癥狀頸動(dòng)脈粥樣硬化患者全因死亡率以及心腦血管疾病致死率密切相關(guān),且高血清尿酸水平提示患者預(yù)后不良。
[Abstract]:Objective to investigate the significance of serum uric acid level in predicting the long-term prognosis of patients with non-neurotic carotid atherosclerosis. Methods 656 patients with non-neurotic carotid atherosclerosis admitted to Cangzhou Central Hospital from December 2012 to December 2015 were collected. Clinical data of patients. According to the quartile spacing of serum uric acid level, the patients were divided into 75% groups, which were divided into 75% groups. The sex of the patients was analyzed retrospectively. Age, body mass index (BMI), complications (hypertension, diabetes, hyperlipidemia, smoking, biochemical index [serum uric acid], Hcy level], main end point events (all cause of death, secondary end point events (cardio-cerebrovascular disease death), observation time up to 2015-12-31. Results Sex, hypertension, hyperlipidemia, smoking rate, 4 groups of patients, The difference of serum uric acid level and Hcy level was statistically significant. There were significant differences in total cause mortality and mortality caused by cardiovascular and cerebrovascular diseases in patients with P0.054.The difference was statistically significant (P 0.05) and Spearman rank correlation analysis showed that there was no significant difference between the two groups. The serum uric acid level was positively correlated with the all-cause mortality of patients with non-neurotic carotid atherosclerosis, and the mortality rate of cardiovascular and cerebrovascular diseases was 0.183 鹵0.099 (P = 0.001 鹵0.002), respectively. At the end of the observation, 170 cases of all-cause death were found. The survival curve of all causes of death in 109 patients with cardiovascular and cerebrovascular diseases and the survival curve of cardio-cerebrovascular disease were significantly different (蠂 ~ 2 = 36.100 ~ 16.898 P = 0.001 / 0. 001). Cox proportional risk regression model showed that there was no significant difference between the two groups (蠂 ~ 2 = 36.100, P = 16.898, P = 0.001, P = 0.001, P = 0.001, P < 0.05). Serum uric acid level is an independent factor of death in asymptomatic carotid atherosclerosis patients [RRN 1.02395% CI 1.018 鹵1.028] and cardiovascular and cerebrovascular diseases (RRRN 1.01195% CI1.0081.014). Conclusion Serum uric acid level and death of patients with non-neurotic carotid atherosclerosis are all due to death (P 0.05). The mortality rate of cardiovascular and cerebrovascular diseases is closely related to the mortality rate. High serum uric acid level suggested poor prognosis.
【作者單位】： 河北省滄州市中心醫(yī)院神經(jīng)內(nèi)三科;河北省滄州市中心醫(yī)院老年病房;
【基金】：滄州市科技計(jì)劃項(xiàng)目(151302138)
【分類(lèi)號(hào)】：R543.4

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