Povezanost koncentracije urične kiseline u serumu i ishoda sustavnog trombolitičkog liječenja akutnog infarkta mozga alteplazom

doctoral thesis

• Title (english): Correlation of serum uric acid level and the efficacy of systemic thrombolyses with alteplase in acute ischemic stroke
• Author: Vesna Matijević; MBZ: 226593
• Mentor: Zdravka Poljaković (mentor)
• Committee member: nije dostupno (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2011-07-07, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences
• Universal decimal classification (UDC): 61 - Medical sciences

Abstract

Objavljen je niz epidemioloških studija s kontroverznim rezultatima o povezanosti povišene razine urične kiseline u serumu i ishoda cerebrovaskularnih bolesti. Neke studije ukazuju na povezanost hiperuricemije s češćom pojavom i lošijim ishodom liječenja akutnog infarkta mozga, dok rezultati ostalih ukazuju na moguću protektivnu ulogu urata, koja se temelji na njihovom antioksidativnom potencijalu. Prateći rezultate ishoda sustavnog trombolitičkog liječenja naše grupe bolesnika s utvrđenim vrijednostima serumske urične kiseline unutar 24 sata od nastanka infarkta mozga nismo utvrdili povezanost viših razina urata i lošijeg ishoda liječenja. Bolesnici s višim razinama urične kiseline imali su više sistoličke i dijastoličke tlakove, te niži NIHSS bodovni zbroj kod prijama. Isti bolesnici imali su rjeđe komplikaciju intracerebralnog krvarenja od onih s nižim vrijednostima urične kiseline, a kao graničnu vrijednost utvrdili smo serumsku razinu od 256 μmol/L. Bolesnici s višim vrijednostima urične kiseline imali su češće fibrilaciju atrija kao čimbenik rizika. Naši su rezultati stoga sukladni rezultatima ispitivanja koja upućuju na moguću protektivnu ulogu urata kod bolesnika s akutnim ishemijskim moždanim udarom, liječenima trombolitičkom terapijom.

Abstract (english)

A large number of epidemiological studies reported controverse association between elevated serum levels of uric acid and stroke outcome. Results of some studies show link between increasing serum urate level and worse outcome and risk of early clinical deterioration after acute stroke. Others report a protective, antioxidant role of uric acid that inffluence positively on recanalization succes and reduce infarct volume size, and thus better clinical recovery. Following clinical outcome of our thrombolised patients with defined levels of serum uric acid in 24 hours after stroke onset period, we didn't find worse outcome in those with elevated serum uric acid. Patients with higher uric acid levels had higher sistolic an dyastolic blood pressure at admission, and lower NIHSS score. Significant lower proportion of intracerebral bleeding occured in patients with higher uric acid levels, and we defined cut off value as 256 μmol/L. Patients with higher uric acid level had atrial flutter more frequently than others. Our results are consistent with the results of possible neuroprotective role of uric acid in patients with stroke treated with thrombolytic therapy.

• Keywords: medicina
• Keywords (english): medicine
• Language: croatian
• URN:NBN: urn:nbn:hr:105:093542
• Study programme: Title: Biomedicine and Health Sciences; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstva (doktor/doktorica znanosti, područje biomedicine i zdravstva)
• Type of resource: Text
• Extent: 107 str.
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-05-05 06:36:13