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| The clinical significance of serum uric acid in non- cardioembolic ischemic stroke |
| LIU Bingfan, LIN Shao-peng, LIN Pei-yi, JIANG Hui-lin, LI Yun-mei, FAN Yong-xiang, WU Ke-ping, CHEN Xiao- hui |
| Department of Emergency, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China |
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Abstract Objective To investigate the clinical significance of serum uric acid（SUA）levels in acute non- cardioembolic ischemic stroke patients. Methods Patients with documented definite large-artery atherosclerosis（LAA）and small-artery occlusion lacunar（SAA）stroke according to the TOAST classification（combined into non-cardioembolic ischemic stroke）, older than 18 years, and visit⁃ ing the Second Affiliated Hospital of Guangzhou Medical University from January 2011 to April 2014 were enrolled in the study. At baseline, demographic data（age, sex）were obtained. All blood samples were obtained at the first day of admission. Uricase-peroxidase method has been adopted as a determina⁃ tion of serum uric acid（UA）concentration. All patients received treatment according to the currentguidelines. The NIHSS score was assessed on admission. The modified Rankin Scale（mRS）score was assessed at discharge. A score of greater than 2 on the mRS was used to define a poor functional outcome at discharge. TOAST classification was classified according to MR, DSA, echocardiography, carotid ultra⁃ sound examination re sults and so on. DWI infarct volumes（DIV）were measured using 32-bit OsiriX imaging software. Descriptive and frequency statistical analyses were obtained and comparisons were per⁃ formed with SPSS for Windows, version 13. 0. A probability value＜0. 05 was considered statistically sig⁃ nificant. Results A total of 516 cases of LAA and SAA ischemic stroke patients（combined non-car⁃ dioembolic ischemic stroke group）took part in this study. The patients were divided into quintile groups depending on serum SU levels: first quintile, 259 μmol/L and below; second quintile, 259 μmol/L through 310 μmol/L; third quintile, 310 μmol/L through 366 μmol/L; fourth quintile, 366 μmol/L through 425 μmol/L; fifth quintile, above 425 μmol/L. Those with lower UA levels were more likely to have poor outcome（P＜0. 05）. However, the proportion of NIHSS≥12 scores and progressive stroke dif⁃ ference between the five groups has no statistical difference（P＞0. 05）. The cerebral infarction volume of low serum uric acid levels（≤259 μmol/L）group and high serum uric acid levels（＞259 μmol/L） group were 1. 512（7. 894）cm3 and 1. 018（3. 363）cm3, respectively. There was statistical difference between two groups（Z＝2. 032，P＝0. 042）. Conclusion Lower serum uric acid level may be unfavor⁃ able to the short-term prognosis of acute non-cardioembolic ischemic stroke. Acute phase serum uric acid is associated with infarct volume and can be used as an index for assessing stroke lesion severity early. The relationship between uric acid and stroke needs to be further investigated.
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Received: 12 March 2016
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Corresponding Authors:
CHEN Xiao-hui, E-mail: cxhgz168@126. com
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