Abstract: Objective　To compare the effect of aspirin combined atorvastatin and aspirin alone on hyperuricemia incidence and recurrence rate of stroke in ischemic stroke patients.Methods　120 patients with ischemic stroke who met the inclusion criteria and were admitted to the Department of Neurology,Beijing Tian Tan Hospital,Capital Medical University from March 2012 to March 2013 were selected.All patients were randomly divided into two groups of combination therapy group and monotherapy group,each of 60 patients.Combination therapy group were given aspirin combined atorvastatin,and monotherapy group were given aspirin alone.General information including gender,age,the United States National Institutes of Health Stroke Scale （NIHSS） score,smoking rate,alcohol consumption,incidence of hypertension and diabetes were compared between the two groups.The hyperuricemia incidence and stroke recurrence rate were detected after 6-weeks treatment in each group.Results　There was no significant difference between the two groups in gender,age,NIHSS score,smoking rate,alcohol consumption,incidence of hypertension and diabetes（P>0.05）.Hyperuricemia incidence and stroke recurrence rate were 18.3% （11/60） and 8.0% （5/60）in monotherapy group and 6.7% （4/60） and 5.0% （3/60） in the combination therapy group,respectively.There was no significant difference in the two indexes（χ2 value was 3.733 and 0.134,P>0.05）.Multiple Logistic regression analysis showed that after adjustment with confounding factors,neither combination therapy nor monotherapy had effect on hyperuricemia〔β=0.986，SE=0.737，Wald χ2=0.463，OR=2.680，95%CI（0.967，7.744）,P>0.05〕 and stroke recurrence 〔β=0.220，SE=0.296，Wald χ2=0.150，OR=1.246，95%CI（0.479,5.883）,P>0.05〕 in ischemic stroke patients.Conclusion　There were no obvious advantages in aspirin combined with atorvastatin and aspirin alone in reducing hyperuricemia incidence and recurrent rate of stroke in ischemic stroke patients.Further research with larger sample and longer follow-up was suggested.

Key words: Stroke, Aspirin, Atorvastatin, Hyperuricemia, Comparative effectiveness research

摘要： 目的　比较阿司匹林联合阿托伐他汀和单独阿司匹林对缺血性卒中患者高尿酸血症发生率和卒中复发率的影响。方法　选取2012年3月—2013年3月首都医科大学附属北京天坛医院神经内科收治的符合纳入标准的缺血性卒中患者120例，采用随机数字表法分为联合用药组和单独用药组,每组60例。联合用药组患者给予阿司匹林联合阿托伐他汀治疗，单独用药组患者单独给予阿司匹林治疗。比较两组患者的一般资料〔性别、年龄、美国国立卫生研究院卒中量表（NIHSS）评分、吸烟率、饮酒率、高血压发生率、糖尿病发生率〕,治疗6个月后检测患者高尿酸血症发生率及卒中复发率。结果　两组患者性别、年龄、NIHSS评分、吸烟率、饮酒率、高血压发生率、糖尿病发生率比较，差异均无统计学意义（P>0.05）。单独用药组患者高尿酸血症发生率、卒中复发率分别为18.3%（11/60）、8.0%（5/60），联合用药组患者高尿酸血症发生率、卒中复发率分别为6.7%（4/60）、5.0%（3/60）；两组患者高尿酸血症发生率及卒中复发率比较，差异无统计学意义（χ2值分别为3.733、0.134，P>0.05）。多因素Logistic回归分析结果显示，在调整混杂因素后，单独用药或联合用药对缺血性卒中患者是否发生高尿酸血症〔β=0.986，SE=0.737，Wald χ2=0.463，OR=2.680，95%CI（0.967，7.744），P>0.05〕、是否卒中复发〔β=0.220，SE=0.296，Wald χ2=0.150，OR=1.246，95%CI（0.479,5.883），P>0.05〕无影响。结论　阿司匹林联合阿托伐他汀较单独阿司匹林在降低缺血性卒中高尿酸血症发生率和卒中复发率中未体现出明显优势，有待进一步增加样本量和延长随访时间进行观察。

关键词: 卒中, 阿司匹林, 阿托伐他汀, 高尿酸血症, 疗效比较研究