Abstract：【Objective】This study aims to investigate the impact of concomitant hyperuricemia on the thrombolytic prognosis in elderly patients with Cerebral Ischemic Stroke (CIS). 【Methods】 A retrospective analysis of the clinical data of 100 elderly CIS patients was conducted. Upon admission and after 7 days of thrombolytic treatment, patients were grouped based on the National Institutes of Health Stroke Scale (NIHSS): with scores ≥5 indicating severe cerebral infarction and scores <5 indicating mild cerebral infarction. Initially, 52 patients were classified as the severe group and 48 as the mild group. After 7 days of thrombolytic treatment, there were 31 cases in the severe group and 69 cases in the mild group. The modified Rankin Scale (mRS) was used to evaluate patient outcomes 90 days post-thrombolysis, with outcomes categorized as mRS scores≤2 (n=63) and mRS scores>2 (n=37). Factors influencing changes in patient conditions and thrombolytic prognosis were analyzed. 【Results】 At admission, there were no statistically significant differences between the two groups in terms of general data, presence of hyperuricemia, total cholesterol, and triglycerides (P>0.05). After 7 days of thrombolysis, the proportion of patients without hyperuricemia and with high total cholesterol in the severe group was greater than that in the mild group (P<0.05). Multivariate logistic regression analysis revealed that high total cholesterol was a risk factor for the severity of condition post-thrombolysis, while hyperuricemia acted as a protective factor (P<0.05). In the mRS scores>2 group, a higher proportion of patients had a history of smoking, hyperuricemia, NIHSS scores ≥5 at admission and NIHSS scores ≥5 at 7 days of thrombolysis than that in the mRS scores≤2 group (P<0.05). Multivariate logistic regression confirmed that concomitant hyperuricemia, smoking history, NIHSS scores ≥5 at admission, and NIHSS scores ≥5 at 7 days of thrombolysis were risk factors for poor 90 days outcomes in elderly CIS patients (P<0.05). 【Conclusion】 Uric acid can act as a protective factor in the early stage of thrombolysis in elderly CIS patients, but it may adversely affect the 90-day prognosis post-thrombolysis. Therefore, managing uric acid levels appropriately at different stages of treatment can effectively improve the treatment and prognosis of elderly CIS.
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2024, Vol. 41 
