摘要
目的:探讨长期高尿酸血症(hyperuricemia,HUA)对慢性肾脏病(chronic renal disease,CKD)血液透析患者生存期的影响。方法:随机选取南通大学附属海安医院肾脏内科住院的CKD血透患者118例,根据其血尿酸(uric acid,UA)水平分为正常UA组和高UA组。患者入组时采集一般资料及生化检测指标。研究时间从2013年1月1日CKD患者接受初次血透开始,追踪至患者死亡或2018年1月1日(最大观察期为6年),记录两组患者预后转归情况。结果:与正常UA组比较,高UA组患者有糖尿病者比例高,血清尿素氮、肌酐、三酰甘油、血清磷、全段甲状旁腺激素水平更高(均P<0.05)。118例患者均获随访,其中死亡71例(60.17%)。Logistic回归分析显示,有糖尿病、血尿素氮、血肌酐及血磷是CKD血液透析患者发生HUA的独立影响因素。多变量COX回归分析表明,患者年龄、动脉高血压、糖尿病、血肌酐、血磷、HUA是患者远期预后的独立预测因素。Kaplan-Meier生存曲线分析显示高UA水平与CKD血液透析患者总生存率的降低显著相关(P<0.001)。结论:高UA水平的CKD血液透析患者的生存期短,预后差。
Objective: To explore the effect of long-term hyperuricemia(HUA) on the survival period of hemodialysis patients with chronic kidney disease. Methods: 118 patients with chronic renal disease(CKD) hemodialysis admitted by the Department of Nephrology of Haian Hospital Affiliated to Nantong University were randomly selected. Serum uric acid(UA) average levels were measured in all patients. HUA occurs when the serum uric acid average level is greater than or equal to 420 mol/L. The general data and biochemical testing indicators were collected. The study was conducted from January 1, 2013,when CKD patients received their first hemodialysis, to the date of death or January 1, 2018(the maximum observation period was 6 years). The prognosis and outcomes were recorded in the two groups. Results: Compared with the normal uric acid group, patients in the high-uric acid group had a higher proportion of diabetes, and higher levels of serum urea nitrogen,creatinine, triglyceride, serum phosphorus and parathyroid hormone. During the follow-up period, 118 cases completely obtained the effective followed up, among them 71 cases died, the mortality rate was 60.17%. The Logistic regression analysis showed that diabetes, blood urea nitrogen, blood creatinine and blood phosphorus were independent influencing factors of HUA occurrence in patients with CKD hemodialysis. Multivariate COX regression analysis showed that age, arterial hypertension, diabetes, serum creatinine, serum phosphorus and HUA were independent predictors of long-term prognosis.Kaplan-Meier survival curve analysis showed that high uric acid level was significantly associated with decreased overall survival rate in CKD hemodialysis patients(P<0.001). Conclusion: Patients with CKD hemodialysis with high uric acid level have a short life span and poor prognosis.
作者
王德琴
周永华
缪娴静
陈宇
高健
WANG Deqin;ZHOU Yonghua;MIAO Xianjing;CHEN Yu;GAO Jian(Department of Nephrology,the Haian Hospital Affiliated to Nantong University,Haian 226600)
出处
《南通大学学报（医学版）》
2020年第1期36-39,共4页
Journal of Nantong University(Medical sciences)
基金
南通市社会事业科技创新与示范计划项目(qyz15054)。
关键词
高尿酸血症
慢性肾脏病
血液透析
生存期
hyperuricemia
chronic kidney disease
hemodialysis
survival time
