Correlation of serum uric acid and homocysteine levels with prognosis of ischemic stroke patients at discharge
Objective To explore the correlation of serum uric acid(SUA)and homocysteine(Hcy)levels with prognosis of ischemic stroke patients at discharge.Methods The clinical data of 125 patients with acute ischemic stroke admitted at Affiliated Jinhua Hospital of Zhejiang University School of Medicine,from January 2021 to June 2022 were retrospectively analyzed.The National Institute of Health stroke scale(NIHSS)was used to assess the severity of stroke,and the prognosis was determined based on the modified Rankin scale(mRS)score at discharge.The binary logistic regression analysis was used to identify independent risk factors for poor prognosis of ischemic stroke;Spearman correlation analysis was used to explore the correlation of SUA and Hcy levels with NIHSS score and mRS score;ROC curve analysis was used to examine the efficacy of SUA and Hcy levels in predicting poor prognosis of ischemic stroke.Results There were 93 cases with good prognosis and 32 cases with poor prognosis at discharge.Age,proportion of diabetes history,NIHSS score at admission,NIHSS score at discharge,mRS score at discharge,length of hospital stay,WBC level,GLU level,Hcy level in the poor prognosis group were higher than those in the good prognosis group(all P＜0.05),and the level of SUA in poor prognosis group was lower than that in the good prognosis group(P＜0.05).High Hcy level(OR=1.479,95％CI:1.168-1.872,P=0.001)was independent risk factors for poor prognosis in ischemic stroke.The level of SUA was negatively correlated with the NIHSS score at admission,the NIHSS score at discharge,and the mRS score at discharge(r=-0.267、-0.248、-0.275,P=0.003、0.005、0.002).The Hcy level was positively correlated with NIHSS score at admission,NIHSS score at discharge,mRS score at discharge,and length of hospital stay(r=0.526、0.496、0.555、0.433,all P＜0.001).The AUC of SUA level in predicting poor prognosis of ischemic stroke patients was 0.700(95％CI:0.595-0.806,P=0.001),with an optimal cutoff value of 328 μmol/L,the sensitivity and specificity was 0.844 and 0.484,respectively.The AUC of Hcy level in predicting poor prognosis was 0.902(95％CI:0.827-0.976,P＜0.001),with the optimal cutoff value of 12.1 μmol/L,the sensitivity and the specificity was 0.813 and 0.935,respectively.The AUC of SUA and Hcy in combination for predicting poor prognosis of ischemic stroke was 0.905(95％CI:0.830-0.979,P＜0.001)with a sensitivity of 0.875 and a specificity of 0.892.Conclusion The levels of SUA and Hcy are closely related to the disease severity and discharge prognosis in patients with ischemic stroke.
万方数据
维普
