高血压, 血尿酸与CISS 亚型相关性的研究李珂王献洪丽(455000 河南安阳) 安阳市地区医院神经内科张晓峰(450001 河南郑州) 郑州大学公共卫生学院.doc

高血压、血尿酸与CISS亚型相关性的研究 李珂 王献 洪丽 （455000河南 安阳）安阳市地区医院神经内科 张晓峰 （450001 河南 郑州）郑州大学公共卫生学院 【摘要】目的 探讨高血压、血尿酸与脑梗死CISS亚型的关系。方法 回顾性分析急性缺血性脑梗死患者，检测其危险因素，包括血压和血尿酸，通过进行头颅DWI、MRA、TCD、心电图、心脏彩超等检查，必要时完善全脑血管造影检查，明确脑梗死患者的中国缺血性卒中亚型（CISS），通过统计学分析，研究血压和血尿酸与脑梗死CISS亚型的关系。结果 高收缩压与各亚型的关系并没有特殊差异，血尿酸水平升高与大动脉粥样硬化性脑梗死有关（OR=0.77，P0.001）。结论 血尿酸水平升高与大动脉粥样硬化性脑梗死有关，该结果对临床个体化预防与治疗有一定的指示意义。 【关键词】高血压；血尿酸；中国缺血性卒中亚型 【中图法分类号】R743.32 Study on the relationships between Hypertension, Blood uric acid and stroke subtypes of CISS Li Ke, Wang Xian, Hong Li (Department of Neurology, Anyang Area Hospital, Anyang 455000 Henan) XiaoFeng Zhang,? （Nutrition Food Hygiene College of Public Health Zhengzhou University, Zhengzhou 450001 Henan） 【Abstract】Objective To explore the relationships between Hypertension, Blood uric acid and stroke subtypes of CISS. Methods The clinical data of patients with acute cerebral infarction were analyzed retrospectively. Risk factors included blood pressure and blood uric acid. The subtype patients were identified according to the China Ischemic Stroke Subclassification (CISS) by diffusion weighted imaging (DWI), magnetic resonance angiography (MRA), transcranial doppler sonography (TCD), electrocardiogram, echocardiography, et al, and digital subtraction arteriography (DSA) if necessary. The relationships were established by statistics. Results There were no difference in the relationships of high contractive pressure and subtypes of CISS. High uric acid was associated with large artery atherosclerotic cerebral infarction (LAA) （OR=0.77，P0.001）. Conclusions High uric acid was associated with large artery atherosclerotic cerebral infarction, which may indicate us to improve the individual therapy in brain ischemia. 【Key Words】Hypertension, blood uric acid ; CISS CISS分型是目前最新的基于病因及发病机制对脑梗死进行分型的方法，完善了以往TOAST分型的不足，对脑梗死的诊断治疗及二级预防具有重要的指导意义[1]。按照CISS分型，急性脑梗死可分为大动脉粥样硬化性、心源性、穿支动脉病变性、其他原因和原因不明五型，而大动脉粥样硬化又根据发病机制分为载体动脉（斑块或血栓）堵塞穿支、动脉到动脉栓塞、低灌注\栓子清除下降和多种机制。然而在实际工作中，分型需要许多辅助检查的支持，费用昂贵，无法在患者入院时及时完