王雅泉

[摘要] 目的 分析血尿酸在合并颈动脉斑块的急性缺血性脑卒中患者病程中的变化，观察别嘌醇对临床神经功能缺损评分的影响，探讨别嘌醇对这类患者的治疗效果。 方法 选择我院2016年8月～2017年1月合并颈动脉斑块的急性缺血性脑卒中患者120例，并随机分为实验组与对照组，对照组按缺血性脑卒中常规治疗，实验组在常规治疗基础上加用别嘌醇口服，比较两组治疗有效率及三个时间点的血尿酸的变化与临床神经功能缺损评分，进行统计学分析对比两组患者的治疗效果。 结果 实验组患者的治疗有效率较高，第5、8天血清尿酸浓度与临床神经功能缺损评分均下降，组间比较差异具有统计学意义（P<0.05）。 结论 （1）合并颈动脉斑块的急性缺血性脑卒中患者病情严重程度与尿酸相关。（2）别嘌醇对合并颈动脉斑块的急性缺血性脑卒中患者有治疗作用。

[关键词] 急性缺血性脑卒中合并颈动脉斑块；尿酸；别嘌醇；神经功能缺损评分

[中图分类号] R743.3 [文献标识码] A [文章编号] 2095-0616（2017）07-243-03

Influence of allopurinol on clinical prognosis of patients with acute ischemic stroke complicated with carotid plaque

WANG Yaquan

Hospital of Chang'an Dongguan，Dongguan 523843，China

[Abstract] Objective To analyze the changes of serum uric acid in the disease course of patients with acute ischemic stroke complicated with carotid plaque，to observe the influence of allopurinol on clinical neurological impairment score and to explore the curative effect of allopurinol on these patients. Methods 120 patients with acute ischemic stroke complicated with carotid plaque who were admitted to our hospital from August 2016 to January 2017 were selected and they were randomly allocated to the experimental group and control group.The control group was given routine treatment of ischemic stroke while the experimental group was given oral allopurinol at the basis of routine treatment.Effective rate of treatment，changes of serum uric acid on three time points and clinical neurological disfunction score of two groups were compared.In addition，curative effects of two groups were given a statistical analysis. Results Effective rate of treatment of patients in the experimental group was higher.And the serum uric acid concentration and clinical neurological disfunction score were both decreased on the fifth day and the eighth day.There was significant difference between two groups and the difference was statistically significant （P<0.05）. Conclusion The severity of patients with acute ischemic stroke complicated with carotid plaque is related to uric acid.Allopurinol has a therapeutic effect on patients with acute ischemic stroke complicated with carotid plaques.

[Key words] Acute ischemic stroke complicated with carotid plaque；Uric acid；Allopurinol；Clinical neurological disfunction

急性缺血性腦卒中是指由于多种因素导致脑组织血液供应障碍，缺氧、缺血引起局灶性脑组织缺血性坏死或软化而造成的系统性神经功能疾病，具有发病率高、死亡率高和致残率高的特点，是神经系统常见病和多发病，更是与心脏疾病及恶性肿瘤共同构成人类的三大死因[1]。根据流行病学资料，近年来脑卒中每年的发病率都在不断攀升，严重威胁人们的身心健康，大大降低患者的生活质量，因此，最大程度地恢复脑卒中患者的神经功能业已成为临床研究和治疗的重点。脑卒中与动脉硬化密不可分[2]，多数卒中患者并存颈动脉粥样硬化这一临床现象，而颈动脉硬化势必加重脑卒中患者的病情。……