维持性血液透析患者血尿酸水平与心血管疾病的关系研究

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摘要目的分析维持性血液透析患者血尿酸（UA）水平与心血管疾病的关系。方法选择我院2018年6月～2019年8月收治的慢性肾功能不全维持性血液透析患者123例，根据UA正常参考值420 μmol/L为分界点将患者分成两组，即UA升高组（n=78）和UA正常组（n=45），利用全自动生化仪测定血清总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、UA、血肌酐（Scr）和血尿素氮（BUN）。结果 UA升高组年龄、男性占比、高血压患病时间、吸烟者占比、透析后冠心病的发生率、Scr、UA、LDL-C、TG 均高于UA正常组，差异有统计学意义（P＜0.05）；而HDL-C 低于UA正常组，差异有统计学意义（P＜0.05）。两组之间体重质量指数、透析时间、是否患有糖尿病、TC水平比较差异均无统计学意义（P＞0.05）。Logistic回归分析显示：TG（β=1.582，OR=4.867，95%CI=3.284～6.355）、LDL-C（β=2.547，OR=12.766，95%CI=10.576～15.423）和透析后患有冠心病（β=2.207，OR=9.085，95%CI=6.702～11.247）是UA升高的独立危险因素（P＜0.05），其中和LDL-C关系更为密切。UA＞420 μmol/L（β=0.138，OR=1.148，95%CI=1.002～1.303）和BUN（β=1.412，OR=4.105，95%CI=2.695～5.587）是透析后患冠心病的独立危险因素（P＜0.05），而UA＞420 μmol/L 对其影响更为密切。结论维持性血液透析患者UA水平是血透患者发生心血管疾病的危险因素，且与脂质代谢紊乱有关。

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	李娜

关键词 ：维持性血液透析, 血尿酸, 血脂, 冠心病

Abstract：Objective To analyze the association of blood uric acid (UA) with cardiovascular disease inuremia patients receiving maintenance hemodialysis.Methods A total of 123 patients with chronic hepatic insufficiency maintenance hemodialysis who chose to visit our hospital from June 2018 to August 2019 were divided UA elevated group (n=78)and UA normal group (n=45) according to the UA normal reference value of 420 μmol/L as the cut-off point.Total cholesterol (TC), triglyeride (TG), low density cholesterol (LDL-C) and high-density cholesterol (HDL-C), serum creatinine (Scr) and blood urea nitrogen (BUN) were evaluated by automatic biochemistry analyser.Results Age, proportion of males, prevalence of hypertension, proportion of smokers, incidence of coronary heart disease after dialysis, Scr, UA,LDL-C, and TG in the elevated UA group were higher than those in the normal UA group, and the differences were statistically significant (P＜0.05);while HDL-C was lower than that in the UA normal group, the difference was statistically significant (P＜0.05).There were no significant differences in BMI, age, diabetes mellitus and TC between the two groups(P＞0.05).Logistic analysis showed that TG (β=1.582, OR=4.867, 95%CI=3.284-6.355), LDL-C (β=2.547, OR=12.766, 95%CI=10.576-15.423) and coronary heart disease after dialysis (β=2.207, OR=9.085, 95%CI=6.702-11.247)were the independent risk factors for the increase of serum uric acid (P＜0.05), among which LDL-C was more closely related.UA＞420 μmol/L (β=0.138, OR=1.148, 95%CI=1.002-1.303) and BUN (β=1.412, OR=4.105, 95%CI=2.695-5.587) were the risk factors of coronary heart disease after dialysis (P＜0.05), but UA＞420 μmol/L was more closely related to them.Conclusion Serum uric acid level in maintenance hemodialysis patients is a risk factor for cardiovascular disease in hemodialysis patients and is related to disorders of lipid metabolism

Key words： Maintenance hemodialysis Blood uric acid Inflammatory factor Coronary heart disease

作者简介: 李娜（1984-），女，硕士，主治医师，研究方向：肾内科疾病的临床研究

引用本文:

李娜. 维持性血液透析患者血尿酸水平与心血管疾病的关系研究[J]. 中国当代医药, 2020, 27(23): 17-20.
LI Na. Association of biood uric with cardiovascular disease in patients with maintenance hemodialysis. 中国当代医药, 2020, 27(23): 17-20.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2020/V27/I23/17

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