目的探讨血清尿酸水平(SUA)与急性缺血性脑卒中(AIS)患者不良预后的相关性。方法连续收集2011年1月至2013年9月兴宁市人民医院住院诊断为AIS患者463例。测量其入院SUA水平,分析SUA与在随访期30 d,3、6、12个月时使用改良Rankin量表(mRS)所评价的预后功能之间的相关性。mRS评分为0~1时视为预后良好。结果研究共纳入463例患者,52%为男性,平均年龄68岁。入院时SUA平均水平为(6.1±3.7)mg/dl。与高SUA水平患者相比,SUA≤4.5 mg/dl患者的30 d良好预后的比例更高(P=0.004)。尚不能认为SUA与30 d病死率或功能不良相关。同时,尚不能认为与卒中后3、6、12个月不良预后相关。然而,在校正年龄、性别、卒中类型和严重程度(NIHSS<9)、卒中发作后时间、血清肌酐、高血压、糖尿病和吸烟后,SUA水平≤4.5 mg/dl与短期良好预后呈正相关(比值比=1.76,95%可信区间为1.05~2.95,阴性预测值=81.1%),而尚不能认为与随访3、6或12个月的预后相关。与高水平SUA患者相比,SUA≤4.5 mg/dl患者往往年龄<55岁、多为女性、轻度中风、血清肌酐水平正常、很少患高血压。尚不能认为从卒中发作到入院的时间与AIS严重程度或SUA水平相关。结论低SUA水平与短期良好预后相关,SUA是脑梗死程度的指标,而不是卒中预后的独立危险因素。 Objective To investigate the relationship between serum uric acid level (SUA) and poor prognosis in patients with acute ischemic stroke (AIS). Methods A total of 463 AIS patients were diagnosed as hospitalized in Xingning People’s Hospital from January 2011 to September 2013. The admission SUA level was measured and the correlation between SUA and the prognostic function assessed by modified Rankin Scale (mRS) at 30 d, 3, 6 and 12 months after follow-up was analyzed. A mRS score of 0 to 1 was considered good prognosis. Results A total of 463 patients were enrolled in the study, 52% were men and the mean age was 68 years. The average SUA at admission was (6.1 ± 3.7) mg / dl. Patients with SUA ≤ 4.5 mg / dl had a higher proportion of good outcomes at 30 days than those with higher SUA (P = 0.004). SUA can not yet be considered as a 30-day mortality or dysfunction. At the same time, it can not be considered to be associated with poor prognosis at 3, 6 and 12 months after stroke. However, a SUA level of 4.5 mg / dL was positively correlated with short-term good prognosis after adjusting for age, gender, stroke type and severity (NIHSS <9), post stroke stroke, serum creatinine, hypertension, diabetes and smoking Ratio = 1.76, 95% confidence interval was 1.05-2.95, negative predictive value = 81.1%), but not yet considered to be associated with a 3, 6 or 12-month follow-up. Compared with patients with high SUA, patients with SUA ≤ 4.5 mg / dl are often younger than 55 years old, mostly female, with mild stroke, normal serum creatinine, and very few high blood pressure. It can not yet be assumed that the time from onset of stroke until admission is related to the severity of AIS or SUA level. Conclusions Low SUA levels are associated with short-term good prognosis. SUA is an indicator of cerebral infarction severity and not an independent risk factor for stroke prognosis.