摘要
目的探讨高尿酸血症(HUA)对维持性血液透析(MHD)患者心血管危险因素(CRFs)聚集及相关并发症的影响。方法以2018年1月~2019年7月本院肾病内科治疗的280例MHD患者为目标对象,收集其基本资料、常规生化指标及血清尿酸(UA)检测结果。统计HUA、CRFs聚集及相关并发症发生情况,并根据是否发生HUA将患者分为HUA组与nHUA组,统计分析HUA的高危因素及UA与生化指标、CRFs聚集率的关系。结果本组患者中,159例发生HUA,占56.79%。与nHUA组比较,HUA组患者中具有≥2个CRFs者占比明显高,CRFs聚集率显著高(P<0.05);且HUA组高血压、心律失常、高脂血症、血管硬化、主动脉钙化、左心室肥厚、心力衰竭发生率明显高(P<0.05)。与nHUA组相比,HUA组体质量指数(BMI)、收缩压、舒张压、甘油三酯、总胆固醇、血清超敏C反应蛋白(hs-CRP)、同型半胱氨酸(Hcy)、内皮素(ET)水平明显高,一氧化氮(NO)水平明显低(P<0.05),Logistic回归分析得出上述因素与CRFs聚集率均为MHD患者发生HUA的危险因素(P<0.05)。Pearson相关性分析显示血清UA浓度与BMI、收缩压、舒张压、甘油三酯、总胆固醇、hs-CRP、Hcy、ET、NO及CRFs聚集率均有明显相关性(P<0.05)。结论 MHD患者HUA发生风险高,HUA除了与肥胖、高血脂、高血压、炎症反应、内皮功能紊乱有关外,还与CRFs聚集密切相关,其可增加心血管并发症发生风险,故应密切监测患者UA水平变化。
Objective To investigate the effect of hyperuricemia(HUA) on the accumulation of cardiovascular risk factors(CRFs) and related complications in patients with maintenance hemodialysis(MHD). Methods A total of 280 MHD patients treated in the department of nephrology in our hospital from January 2018 to July 2019 were enrolled. The basic data, routine biochemical parameters and serum uric acid(UA) test results were collected. The HUA, CRFs aggregation and the occurrence of related complications were counted. The patients were divided into HUA group and nHUA group according to whether HUA occurred. The relationship between HUA risk factors and UA and biochemical indicators and CRFs aggregation rate was analyzed statistically. Results Of the patients in this group, 159 cases occurred HUA,accounting for 56.79%. Compared with that of the nHUA group, the proportion of patients with ≥2 CRFs in the HUA group was significantly higher, and the CRFs aggregation rate was significantly higher(P<0.05). And the HUA group had higher incidences of hypertension, arrhythmia, hyperlipidemia, hardening of the arteries, and aorta calcification, left ventricular hypertrophy, and heart failure(P<0.05). Compared with those of nHUA group, the levels of body mass index(BMI), systolic blood pressure, diastolic blood pressure, triglyceride, total cholesterol, serum high-sensitivity C-reactive protein(hs-CRP), homocysteine(Hcy) and endothelium(ET) in HUA group were significantly higher, and the level of nitric oxide(NO) was significantly lower(P<0.05). Logistic regression analysis showed that the above factors and the aggregation rate of CRFs were risk factors for HUA in patients with MHD(P<0.05). Pearson correlation analysis showed that serum UA concentration was significantly correlated with BMI, systolic blood pressure, diastolic blood pressure, triglyceride, total cholesterol, hs-CRP, Hcy, ET, NO and CRFs aggregation rate(P<0.05). Conclusion The risk of HUA in patients with MHD is high. In addition to obesity, hyperlipidemia, hypertension, inflammatory reaction and endothelial dysfunction, HUA is also closely related to the accumulation of CRFs, which may increase the risk of cardiovascular complications. Therefore, the UA level changes in patients should be closely monitored.
作者
陈璐
陈伟珍
王莎莎
徐丽云
CHEN Lu;CHEN Weizhen;WANG Shasha;XU Liyun(Blood Purification Center,Taizhou Hospital of Zhejiang Province,Taizhou317000,China)
出处
《中国现代医生》
2020年第3期105-108,112,共5页
China Modern Doctor
基金
浙江省医药卫生科技计划项目(2018KY882)。
关键词
高尿酸血症
维持性血液透析
心血管危险因素聚集
并发症
Hyperuricemia
Maintenance hemodialysis
Cardiovascular risk factors accumulation
Complications
