CAJ | 학술논문

目的虽然终末期肾病患者高尿酸血症发生率很高,血液透析对血尿酸清除情况及其影响因素仍需进一步评估.方法对本血液透析中心治疗的200例连续患者进行透析前、后血尿酸、肌酐及胱抑素C等水平监测,研究高尿酸血症患者的发生率及其影响因素.结果患者透析前平均尿酸水平为(501±158)μmol/L,其中男性为(527±170) μmol/L,女性为(455±123)μmol/L,透析前男、女性平均尿酸水平比较差异有统计学意义(P＜0.01)；高尿酸血症发生率为72.0％,其中男性为72.7％,女性为70.8％,男、女性高尿酸血症发生率比较差异无统计学意义(P＞0.05)；透析后血尿酸水平及高尿酸血症发生率比较差异有统计学意义(P＜0.01)；男、女性间比较差异无统计学意义(P＞0.05).在透析较充分的患者中,透析前、后平均尿酸水平及高尿酸血症发生率均低于透析不充分或新开始透析的患者(P＜0.01).单次透析尿酸清除率显著高于肌酐、尿素和胱抑素C的清除率(P均＜0.01).结论透析患者透析前尿酸水平及高尿酸血症发生率均很高；透析对尿酸有较好地清除率,透析充分性对患者透析前、后尿酸水平及高尿酸血症发生率均有影响,透析后尿酸水平及高尿酸血症发生率低于普通人群.
목적 수연종말기신병환자고뇨산혈증발생솔흔고,혈액투석대혈뇨산청제정황급기영향인소잉수진일보평고.방법 대본혈액투석중심치료적200례련속환자진행투석전、후혈뇨산、기항급광억소C등수평감측,연구고뇨산혈증환자적발생솔급기영향인소.결과 환자투석전평균뇨산수평위(501±158)μmol/L,기중남성위(527±170) μmol/L,녀성위(455±123)μmol/L,투석전남、녀성평균뇨산수평비교차이유통계학의의(P＜0.01)；고뇨산혈증발생솔위72.0％,기중남성위72.7％,녀성위70.8％,남、녀성고뇨산혈증발생솔비교차이무통계학의의(P＞0.05)；투석후혈뇨산수평급고뇨산혈증발생솔비교차이유통계학의의(P＜0.01)；남、녀성간비교차이무통계학의의(P＞0.05).재투석교충분적환자중,투석전、후평균뇨산수평급고뇨산혈증발생솔균저우투석불충분혹신개시투석적환자(P＜0.01).단차투석뇨산청제솔현저고우기항、뇨소화광억소C적청제솔(P균＜0.01).결론 투석환자투석전뇨산수평급고뇨산혈증발생솔균흔고；투석대뇨산유교호지청제솔,투석충분성대환자투석전、후뇨산수평급고뇨산혈증발생솔균유영향,투석후뇨산수평급고뇨산혈증발생솔저우보통인군.
Objective Although the incidence of hyperuricemia in the patients with end stage renal disease (ESRD) is very high,the clearance rate of uric acid by hemodialysis and the influence factors need further evaluated.Methods The 200 consecutive patients with ESRD admission to our blood purification center were included to the study.The levels of uric acid,creatirnine and cystatin C were tested,and the incidences of hyperuricemia and influence factors were studied.Results Before dialysis,the mean levels of uric acid were (501±158)μmol/L in all patients,and (527±167)μmol/L and (455±123)μmol/L in males and females,respectively(P＜0.01).The incidences of hyperuricemia were 72.0％ in all patients,and 72.7％ and 70.8％ in males and females,respectively(P＞0.05).After dialysis,the mean levels of SUA and the incidence of HUA were significant lower than before dialysis,and there was no difference between the males and females.Both before and after dialysis,the mean levels of uric acid and incidences of hypericemia were lower in sufficient dialysis patients the in no sufficient dialysis patients(P＜0.01).In a single dialysis session the clearances of uric acid was significantly higher than the clearances of creatinine and cystatin C(P＜0.01).Conclusions In the patients on hemodialysis,the mean level of uric acid and the incidence of hyperuricemia are very high,and the clearance rate of uric acid by hemodialysis is high,but mean level of uric acid and the incidence of hyperuricemia associated with the dosage of hemodialysis.After dialysis,the mean level of uric acid and the incidence of hyperuricemian are lower than the ordinary population.