高龄老年男性高尿酸血症与下肢动脉硬化的相关性研究  

The relationship between hyperuricemia and lower extremity atherosclerotic disease in male advanced elderly patients

作　　者：宋长城[1] 张婷[1] 苏伟[1] 操淮芳 钱维原 

机构地区：[1]解放军第四五四医院高干科,南京市210002 [2]解放军第四五四医院超声诊断科,南京市210002

出　　处：《中国临床研究》2013年第5期426-429,共4页Chinese Journal of Clinical Research

摘　　要：目的探讨高龄老年男性患者血清尿酸(SUA)水平与下肢动脉粥样硬化性疾病(LEAD)的关系。方法选择362例高龄老年男性患者,根据有无高尿酸血症对患者进行分组:高尿酸血症组(76例)及SUA正常组(286例)。进行体格检查,并询问病史,取血行肝功能、肾功能、血糖、血脂、SUA、糖化血红蛋白(HbAlc)、C反应蛋白(CRP)等检测,同时用彩色多普勒超声对患者下肢动脉血管进行检查,分析SUA水平与下肢血管病变发生的相关性。结果 (1)高尿酸血症组体质指数(BMI)、血尿素氮(BUN)、血肌酐(Scr)、三酰甘油(TG)及CRP均明显高于SUA正常组(P均<0.01),HbAlc及高密度脂蛋白胆固醇(HDL-C)显著低于SUA正常组(P均<0.01),且高血压、糖尿病及糖耐量异常、脑卒中、超重或肥胖、肾功能不全等疾病的发生率亦高于SUA正常组(P均<0.01)。(2)高尿酸血症组LEAD的发生率为39.47%,明显高于SUA正常组的28.32%(P<0.01),且下肢动脉直径狭窄程度随着SUA水平的升高而加重。(3)Logistic多元回归分析显示,SUA、TG、高血压、糖代谢异常为高龄老年男性患者发生LEAD的危险因素。结论高龄老年男性患者SUA水平升高与LEAD的发生、发展密切相关,可认为SUA是高龄老年男性患者发生LEAD的独立危险因素。Objective To investigate the relationship between serum uric acid （SUA） level and lower extremity arterial disease （LEAD） in male advanced elderly patients. Methods A total of 362 male advanced elderly patients were selected and divided into two groups based on with or without hyperuricemia：normal SUA group （ n = 286 ） and hyperuricemia group （ n = 76 ）. Bilateral lower limb arteries of all the participants were scanned by high resolution color Doppler ultrasonography. The case history and physical examination were conducted. The functions of liver and kidney and the levels of fasting blood glucose ,glycosylated hemoglobin（ HbAlc）, serum lipid, SUA and C-reactive protein （CRP） were detected. The relationship between SUA level and LEAD was analyzed. Results The body mass index （ BMI）, SUA, blood urea nitrogen （ BUN）, serum creatinine （ Scr）, tfiglyceride （TG） and CRP in the hyperuricemia group were significantly higher than those in the normal SUA group（ all P 〈 0.01 ）, but HbAlc and high-density lipoproteins cholesterol（HDL-C） in hyperuricemia group were significantly lower than those in normal SUA group （ all P 〈 0.01 ）. The prevalence of hypertention, diabetes mellitus, impaired glucose tolerance, stroke, overweight and obesity, kidney insufficiency in the hyperuricemia group were marked higher than those in the normal SUA group（ all P 〈 0. 01 ）. The prevalence of LEAD in the hyperuricemia group was higher than that in the normal SUA group （ 39.47% vs 28.32%, P 〈 0.01 ）, and the stenosis degree of lower limb arteries gradually aggregates with the increase of SUA level. Logistic multiple regression analysis showed that SUA, TG, hypertension and abnormality of glucose metabolism were risk factors of LEAD in male advanced elderly patients. Conclusions The increase of SUA level is closely associated with the occurrence and development of LEAD, and SUA is an independent risk factor of LEAD in male advanced elderly patients.

关 键 词：血清尿酸 动脉粥样硬化 下肢 超声 多普勒 彩色 危险因素 

分 类 号：R543.5[医药卫生—心血管疾病]