中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
22期
18-22
,共5页
金珍木%李素蘋%项光博%徐晓作%朱小春
金珍木%李素蘋%項光博%徐曉作%硃小春
금진목%리소빈%항광박%서효작%주소춘
痛风%尿酸%尿酸排泄分数
痛風%尿痠%尿痠排洩分數
통풍%뇨산%뇨산배설분수
Gout%Uric acid%Fractional excretion of uric acid
目的 探讨尿酸排泄分数与原发性痛风患者血尿酸、体质量指数(BMI)、血压、血糖以及血脂等代谢因素的相关性.方法 选择62例原发性痛风患者为痛风组和32例健康体检者为对照组,痛风组患者按尿酸排泄分数水平分为尿酸排泄减少组29例(尿酸排泄分数＜7％)、混合组25例(7％≤尿酸排泄分数≤12％)和尿酸生成增多组8例(尿酸排泄分数＞12％).抽取患者空腹血,检测血肌酐、血尿酸、血糖、糖化血红蛋白及血脂水平,留取24h尿,测得24 h尿尿酸、尿肌酐,根据公式计算尿酸排泄分数并进行相关性分析.结果 痛风组BMI、平均动脉压、血尿酸、糖化血红蛋白、总胆固醇、餐后2h血糖明显高于对照组,高密度脂蛋白胆固醇、尿酸排泄分数明显低于对照组,差异有统计学意义(P＜0.05);两组年龄、空腹血糖、低密度脂蛋白胆固醇、三酰甘油比较差异无统计学意义(P＞0.05).尿酸排泄减少组、混合组、尿酸生成增多组年龄、血尿酸、空腹血糖、餐后2h血糖、糖化血红蛋白、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇比较差异无统计学意义(P＞0.05);三组BMI、平均动脉压、三酰甘油、尿酸排泄分数比较差异有统计学意义(P＜0.05).对照组和痛风组,尿酸排泄分数与血尿酸均呈负相关(r=-3.900,-0.476,P＜0.05).痛风组尿酸排泄分数与24h尿尿酸呈正相关(r=0.465,P=0.001),与三酰甘油水平呈负相关(r=-0.304,P＜0.05).痛风组Pearson相关分析显示尿酸排泄减少组(尿酸排泄分数＜7％)尿酸排泄分数与血尿酸呈负相关(r=-0.392,P＜0.05),非尿酸排泄减少组(尿酸排泄分数≥7％)尿酸排泄分数与血尿酸呈正相关(r=0.437,P＜0.05),而24h尿尿酸与血尿酸无相关性(P＞0.05).多元Logistic回归分析提示血尿酸、糖化血红蛋白、尿酸排泄分数为痛风发病危险因素(P＜0.05).结论 原发性痛风患者除了血尿酸的明显变化外,还存在血压、血糖和血脂的明显变化,尿酸排泄分数可作为评价原发性痛风患者尿酸排泄能力的指标;平均动脉压、糖化血红蛋白、尿酸排泄分数为痛风发病危险因素.
目的 探討尿痠排洩分數與原髮性痛風患者血尿痠、體質量指數(BMI)、血壓、血糖以及血脂等代謝因素的相關性.方法 選擇62例原髮性痛風患者為痛風組和32例健康體檢者為對照組,痛風組患者按尿痠排洩分數水平分為尿痠排洩減少組29例(尿痠排洩分數＜7％)、混閤組25例(7％≤尿痠排洩分數≤12％)和尿痠生成增多組8例(尿痠排洩分數＞12％).抽取患者空腹血,檢測血肌酐、血尿痠、血糖、糖化血紅蛋白及血脂水平,留取24h尿,測得24 h尿尿痠、尿肌酐,根據公式計算尿痠排洩分數併進行相關性分析.結果 痛風組BMI、平均動脈壓、血尿痠、糖化血紅蛋白、總膽固醇、餐後2h血糖明顯高于對照組,高密度脂蛋白膽固醇、尿痠排洩分數明顯低于對照組,差異有統計學意義(P＜0.05);兩組年齡、空腹血糖、低密度脂蛋白膽固醇、三酰甘油比較差異無統計學意義(P＞0.05).尿痠排洩減少組、混閤組、尿痠生成增多組年齡、血尿痠、空腹血糖、餐後2h血糖、糖化血紅蛋白、總膽固醇、低密度脂蛋白膽固醇、高密度脂蛋白膽固醇比較差異無統計學意義(P＞0.05);三組BMI、平均動脈壓、三酰甘油、尿痠排洩分數比較差異有統計學意義(P＜0.05).對照組和痛風組,尿痠排洩分數與血尿痠均呈負相關(r=-3.900,-0.476,P＜0.05).痛風組尿痠排洩分數與24h尿尿痠呈正相關(r=0.465,P=0.001),與三酰甘油水平呈負相關(r=-0.304,P＜0.05).痛風組Pearson相關分析顯示尿痠排洩減少組(尿痠排洩分數＜7％)尿痠排洩分數與血尿痠呈負相關(r=-0.392,P＜0.05),非尿痠排洩減少組(尿痠排洩分數≥7％)尿痠排洩分數與血尿痠呈正相關(r=0.437,P＜0.05),而24h尿尿痠與血尿痠無相關性(P＞0.05).多元Logistic迴歸分析提示血尿痠、糖化血紅蛋白、尿痠排洩分數為痛風髮病危險因素(P＜0.05).結論 原髮性痛風患者除瞭血尿痠的明顯變化外,還存在血壓、血糖和血脂的明顯變化,尿痠排洩分數可作為評價原髮性痛風患者尿痠排洩能力的指標;平均動脈壓、糖化血紅蛋白、尿痠排洩分數為痛風髮病危險因素.
목적 탐토뇨산배설분수여원발성통풍환자혈뇨산、체질량지수(BMI)、혈압、혈당이급혈지등대사인소적상관성.방법 선택62례원발성통풍환자위통풍조화32례건강체검자위대조조,통풍조환자안뇨산배설분수수평분위뇨산배설감소조29례(뇨산배설분수＜7％)、혼합조25례(7％≤뇨산배설분수≤12％)화뇨산생성증다조8례(뇨산배설분수＞12％).추취환자공복혈,검측혈기항、혈뇨산、혈당、당화혈홍단백급혈지수평,류취24h뇨,측득24 h뇨뇨산、뇨기항,근거공식계산뇨산배설분수병진행상관성분석.결과 통풍조BMI、평균동맥압、혈뇨산、당화혈홍단백、총담고순、찬후2h혈당명현고우대조조,고밀도지단백담고순、뇨산배설분수명현저우대조조,차이유통계학의의(P＜0.05);량조년령、공복혈당、저밀도지단백담고순、삼선감유비교차이무통계학의의(P＞0.05).뇨산배설감소조、혼합조、뇨산생성증다조년령、혈뇨산、공복혈당、찬후2h혈당、당화혈홍단백、총담고순、저밀도지단백담고순、고밀도지단백담고순비교차이무통계학의의(P＞0.05);삼조BMI、평균동맥압、삼선감유、뇨산배설분수비교차이유통계학의의(P＜0.05).대조조화통풍조,뇨산배설분수여혈뇨산균정부상관(r=-3.900,-0.476,P＜0.05).통풍조뇨산배설분수여24h뇨뇨산정정상관(r=0.465,P=0.001),여삼선감유수평정부상관(r=-0.304,P＜0.05).통풍조Pearson상관분석현시뇨산배설감소조(뇨산배설분수＜7％)뇨산배설분수여혈뇨산정부상관(r=-0.392,P＜0.05),비뇨산배설감소조(뇨산배설분수≥7％)뇨산배설분수여혈뇨산정정상관(r=0.437,P＜0.05),이24h뇨뇨산여혈뇨산무상관성(P＞0.05).다원Logistic회귀분석제시혈뇨산、당화혈홍단백、뇨산배설분수위통풍발병위험인소(P＜0.05).결론 원발성통풍환자제료혈뇨산적명현변화외,환존재혈압、혈당화혈지적명현변화,뇨산배설분수가작위평개원발성통풍환자뇨산배설능력적지표;평균동맥압、당화혈홍단백、뇨산배설분수위통풍발병위험인소.
Objective To study the correlation between fractional excretion of uric acid (FEUA) and blood uric acid,body mass index (BMI),blood pressure,blood glucose,blood lipid and other metabolic factors in patients with primary gout.Methods Sixty-two patients with primary gout (gout group) and 32 healthy people (control group) were selected in this study.Gout group was divided into uric acid excretion decreasing group (FEUA ＜ 7％,29 cases),mixed group (7％ ≤FEUA ≤ 12％,25 cases) and uric acid production increasing group (FEUA ＞ 12％,8 cases) according to the level of FEUA.The fasting blood glucose (FPG),2-hour postprandial blood glucose (2 h PBG),blood lipid,serum creatinine,blood uric acid,glycosylated hemoglobin were tested.24 hours urine was collected and urinary uric acid and urinary creatinine was measured,FEUA was calculated and analyzed.Results BMI,mean arterial pressure,blood uric acid,glycosylated hemoglobin,total cholesterol,2 h PBG in gout group was higher than that in control group,and high density lipoprotein cholesterol,FEUA was lower than that in control group,and there was significant difference (P ＜ 0.05).There was no significant difference in age,FPG,low density lipoprotein cholesterol,triacylglycerol between two groups (P＞ 0.05).There was no significant difference in age,blood uric acid,FPG,2 h PBG,glycosylated hemoglobin,total cholesterol,low density lipoprotein cholesterol,high density hpoprotein cholesterol among uric acid excretion decreasing group,mixed group and uric acid production increasing group (P ＞ 0.05),and there was significant difference in BMI,mean arterial pressure,triacylglycerol,FEUA among three groups(P＜ 0.05).FEUA was negatively correlated with blood uric acid in control group and gout group (r =-3.900,-0.476,P ＜0.05).FEUA was positively correlated with 24 h urinary uric acid in gout group (r =0.465,P =0.001),and nagatively correlated with triacylglycerol (r =-0.304,P ＜ 0.05).Pearson analysis showed that FEUA was negatively correlated with blood uric acid in uric acid excretion decreasing group (FEUA ＜ 7％) (r =-0.392,P ＜ 0.05),FEUA was positively correlated with blood uric acid in non uric acid excretion decreasing group (FEUA ≥7％)(r =0.437,P ＜ 0.05),but 24 h urinary uric acid was not correlated with blood uric acid(P ＞ 0.05).Multi-stepwise regression analysis showed that blood uric acid,glycosylated hemoglobin,FEUA was significantly correlated with the onset of the gout (P ＜ 0.05).Conclusions Besides blood uric acid level,there are significant changes in primary gout in blood pressure,serum glucose and lipid levels.FEUA could be used to estimate the ability of renal excrete the uric acid.Mean arterial pressure,glycosylated hemoglobin and FEUA are the risk factors for gout.
