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.
ZHANG Ling,WANG Jia. Impact of Concomitant Hyperuricemia on Thrombolytic Prognosis in Elderly Patients with Cerebral Ischemic Stroke[J]. JOURNAL OF CLINICAL RESEARCH, 2024, 41(10): 1519-1522.
[1] ZHANG S, LIU L, HUANG Y Q, et al. The association between serum uric acid levels and ischemic stroke in essential hypertension patients[J].Postgrad Med,2020,132(6):551-558.
[2] WANG C Y, CUI T, WANG L, et al. Prognostic significance of uric acid change in acute ischemic stroke patients with reperfusion therapy[J].Eur J Neurol,2021,28(4):1218-1224.
[3] LEI Z H, CAI J J, HONG H, et al. Serum uric acid level and outcome of patients with ischemic stroke: A systematic review and meta-analysis[J].Neurologist,2019,24(4):121.
[4] 杜朝品. 高尿酸血症与缺血性脑卒中急性期和远期预后的相关性研究[J].贵州医药,2018,42(12):1488-1489.
[5] 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组. 中国急性缺血性脑卒中诊治指南2018[J].中华神经科杂志,2018,51(9):666-682.
[6] 袁波,谭莉,李鑫,等. 缺血性脑卒中NIHSS评分与卒中抑郁的相关性分析[J].中国神经免疫学和神经病学杂志,2018,25(6):430-432.
[7] 范玉华,姬晓昙,蓝琳芳. 国内脑卒中临床试验疗效判断方法中改良Rankin评分的应用现状[J].中国神经精神疾病杂志,2015(7):412-415.
[8] 范琳,黄晶,吴正刚,等. 尿酸与缺血性脑卒中rt-PA静脉溶栓预后:前瞻性研究[J].中风与神经疾病杂志,2018,35(1):48.
[9] 彭程,张源鑫,林贵英,等. 血尿酸水平与急性缺血性脑卒中预后关系的Meta分析[J].临床荟萃,2020,35(8):677-683.
[10] AMARO S, JIMÉNEZ-ALTAYÔ F, CHAMORRO Á. Uric acid therapy for vasculoprotection in acute ischemic stroke[J].Brain Circ,2019,5(2):55-61.
[11] ZHANG M, WANG Y, WANG K, et al. Association between uric acid and the prognosis of acute ischemic stroke: A systematic review and meta-analysis[J].Nutr Metab Card Dis,2021,31(11):3016-3023.
[12] ALIENA-VALERO A, RIUS-PÉREZ S, BAIXAULI-MARTÍN J, et al. Uric acid neuroprotection associated to il-6/stat3 signaling pathway activation in rat ischemic stroke[J].Mol Neurobiol,2021,58(1):408-423.
[13] SERDAREVIC N, STANCIU A E, BEGIC L, et al. Serum uric acid concentration in patients with cerebrovascular disease (ischemic stroke and vascular dementia)[J].Med Arch,2020,74(2):95-99.
[14] 蒋愈娇,吕艳,李东樱. 高尿酸血症对急性脑梗死病人静脉溶栓结局的影响[J].实用老年医学,2019,33(8):780-782.
2024, Vol. 41 
