{"title":"静脉溶栓后血清尿酸与出血转化的u型关系。","authors":"Zicheng Cheng, Zhenxiang Zhan, Yaming Fu, WenYuan Zhang, Lingfan Xia, Tong Xu, Hongfang Chen, Zhao Han","doi":"10.2174/1567202619666220707093427","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Uric acid (UA) has both antioxidative and pro-oxidative properties. The study aimed to investigate the relationship between serum UA and hemorrhagic transformation (HT) after intravenous thrombolysis in patients with acute ischemic stroke.</p><p><strong>Methods: </strong>The patients undergoing intravenous thrombolysis from two hospitals in China were retrospectively analyzed. HT was evaluated using computed tomography images reviewed within 24- 36h after thrombolysis. Symptomatic intracranial hemorrhage (sICH) was defined as HT accompanied by worsening neurological function. Multivariate logistic regression and spline regression models were performed to explore the relationship between serum UA levels and the risk of HT and sICH.</p><p><strong>Results: </strong>Among 503 included patients, 60 (11.9%) were diagnosed with HT and 22 (4.4%) developed sICH. Patients with HT had significant lower serum UA levels than those without HT (245 [214-325 vs. 312 [256-370] μmol/L, p < 0.001). Multivariable logistic regression analysis indicated that patients with higher serum UA levels had a lower risk of HT (OR per 10-μmol/L increase 0.96, 95%CI 0.92-0.99, p = 0.015). Furthermore, multiple-adjusted spline regression models showed a Ushaped association between serum UA levels and HT (p < 0.001 for non-linearity). Similar results were present between serum UA and sICH. Restricted cubic spline models predicted the lowest risk of HT and sICH when the serum UA levels were 386μmol/L.</p><p><strong>Conclusion: </strong>The data show the U-shaped relationship between serum UA levels and the risk of HT and sICH after intravenous thrombolysis.</p>","PeriodicalId":10879,"journal":{"name":"Current neurovascular research","volume":"19 2","pages":"150-159"},"PeriodicalIF":2.0000,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"2","resultStr":"{\"title\":\"U-Shaped Association Between Serum Uric Acid and Hemorrhagic Transformation After Intravenous Thrombolysis.\",\"authors\":\"Zicheng Cheng, Zhenxiang Zhan, Yaming Fu, WenYuan Zhang, Lingfan Xia, Tong Xu, Hongfang Chen, Zhao Han\",\"doi\":\"10.2174/1567202619666220707093427\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Uric acid (UA) has both antioxidative and pro-oxidative properties. The study aimed to investigate the relationship between serum UA and hemorrhagic transformation (HT) after intravenous thrombolysis in patients with acute ischemic stroke.</p><p><strong>Methods: </strong>The patients undergoing intravenous thrombolysis from two hospitals in China were retrospectively analyzed. HT was evaluated using computed tomography images reviewed within 24- 36h after thrombolysis. Symptomatic intracranial hemorrhage (sICH) was defined as HT accompanied by worsening neurological function. Multivariate logistic regression and spline regression models were performed to explore the relationship between serum UA levels and the risk of HT and sICH.</p><p><strong>Results: </strong>Among 503 included patients, 60 (11.9%) were diagnosed with HT and 22 (4.4%) developed sICH. Patients with HT had significant lower serum UA levels than those without HT (245 [214-325 vs. 312 [256-370] μmol/L, p < 0.001). Multivariable logistic regression analysis indicated that patients with higher serum UA levels had a lower risk of HT (OR per 10-μmol/L increase 0.96, 95%CI 0.92-0.99, p = 0.015). Furthermore, multiple-adjusted spline regression models showed a Ushaped association between serum UA levels and HT (p < 0.001 for non-linearity). Similar results were present between serum UA and sICH. Restricted cubic spline models predicted the lowest risk of HT and sICH when the serum UA levels were 386μmol/L.</p><p><strong>Conclusion: </strong>The data show the U-shaped relationship between serum UA levels and the risk of HT and sICH after intravenous thrombolysis.</p>\",\"PeriodicalId\":10879,\"journal\":{\"name\":\"Current neurovascular research\",\"volume\":\"19 2\",\"pages\":\"150-159\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2022-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"2\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Current neurovascular research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2174/1567202619666220707093427\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current neurovascular research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2174/1567202619666220707093427","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 2
摘要
背景:尿酸(UA)具有抗氧化和促氧化特性。本研究旨在探讨急性缺血性脑卒中患者静脉溶栓后血清UA与出血转化(HT)的关系。方法:回顾性分析国内两家医院静脉溶栓患者的临床资料。使用溶栓后24- 36小时内的ct图像评估HT。症状性颅内出血(siich)定义为HT伴神经功能恶化。采用多因素logistic回归和样条回归模型探讨血清尿酸水平与HT和sICH风险的关系。结果:503例患者中，60例(11.9%)诊断为HT, 22例(4.4%)为siich。HT患者血清UA水平显著低于未HT患者(245 [214-325]μmol/L vs. 312 [256-370] μmol/L, p < 0.001)。多变量logistic回归分析显示，血清UA水平较高的患者发生HT的风险较低(OR每10 μmol/L增加0.96,95%CI 0.92 ~ 0.99, p = 0.015)。此外，多重调整样条回归模型显示血清UA水平与HT之间存在Ushaped相关性(非线性p < 0.001)。血清UA和siich之间也存在类似的结果。当血清UA水平为386μmol/L时，限制三次样条模型预测HT和siich的风险最低。结论:血清UA水平与静脉溶栓后HT、siich发生风险呈u型关系。
U-Shaped Association Between Serum Uric Acid and Hemorrhagic Transformation After Intravenous Thrombolysis.
Background: Uric acid (UA) has both antioxidative and pro-oxidative properties. The study aimed to investigate the relationship between serum UA and hemorrhagic transformation (HT) after intravenous thrombolysis in patients with acute ischemic stroke.
Methods: The patients undergoing intravenous thrombolysis from two hospitals in China were retrospectively analyzed. HT was evaluated using computed tomography images reviewed within 24- 36h after thrombolysis. Symptomatic intracranial hemorrhage (sICH) was defined as HT accompanied by worsening neurological function. Multivariate logistic regression and spline regression models were performed to explore the relationship between serum UA levels and the risk of HT and sICH.
Results: Among 503 included patients, 60 (11.9%) were diagnosed with HT and 22 (4.4%) developed sICH. Patients with HT had significant lower serum UA levels than those without HT (245 [214-325 vs. 312 [256-370] μmol/L, p < 0.001). Multivariable logistic regression analysis indicated that patients with higher serum UA levels had a lower risk of HT (OR per 10-μmol/L increase 0.96, 95%CI 0.92-0.99, p = 0.015). Furthermore, multiple-adjusted spline regression models showed a Ushaped association between serum UA levels and HT (p < 0.001 for non-linearity). Similar results were present between serum UA and sICH. Restricted cubic spline models predicted the lowest risk of HT and sICH when the serum UA levels were 386μmol/L.
Conclusion: The data show the U-shaped relationship between serum UA levels and the risk of HT and sICH after intravenous thrombolysis.
期刊介绍：
Current Neurovascular Research provides a cross platform for the publication of scientifically rigorous research that addresses disease mechanisms of both neuronal and vascular origins in neuroscience. The journal serves as an international forum publishing novel and original work as well as timely neuroscience research articles, full-length/mini reviews in the disciplines of cell developmental disorders, plasticity, and degeneration that bridges the gap between basic science research and clinical discovery. Current Neurovascular Research emphasizes the elucidation of disease mechanisms, both cellular and molecular, which can impact the development of unique therapeutic strategies for neuronal and vascular disorders.
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