累积尿酸暴露与臂踝动脉脉搏波传导速度的关系  

Study on the association between cumulative serum uric acid and brachial-ankle pulse wave velocity

作　　者：王洁蕊[1] 胡玉琴 石慧婧 宋海澄[1] 舒荣[1] 韩依轩[1] 于萍[1] 王健[1] 杨文浩[1] 袁伟[1] 刘白鹭[1] 李娜[1] 杨文芳 李丽娜 吴寿岭[2] 崔刘福[1] Wang Jierui;Hu Yuqin;Shi Huijing;Song Haicheng;Shu Rong;Han Yixuan;Yu Ping;Wang Jian;Yang Wenhao;Yuan Wei;Liu Bailu;Li Na;Yang Wenfang;Li Lina;Wu Shouling;Cui Liufu(Department of Rheumatology,Kailuan General Hospital,Tangshan 063000,China;Department of Cardiology,Kailuan General Hospital,Tangshan 063000,China)

机构地区：[1]开滦总医院风湿免疫科,唐山063000 [2]开滦总医院心内科,唐山063000

出　　处：《中华风湿病学杂志》2019年第4期220-227,共8页Chinese Journal of Rheumatology

基　　金：河北省医学科学研究重点课题(20181447).

摘　　要：目的探讨累积尿酸暴露(cumUA)与臂踝动脉脉搏波传导速度(baPWV)的关系。方法在参加开滦集团2010—2017年4次健康体检的职工中抽取完成1次脉搏波传导速度(PWV)测定的观察对象,除去前3次体检尿酸缺失者及性别数据缺失者,符合入选标准者20688名,删除有缺血性脑卒中(不包括腔隙性脑梗死)、短暂性脑缺血发作、心肌梗死的患者,删除极值者,最终20295名符合入选标准,纳入统计分析。采用逐步线性回归、多因素Logistic回归方法及自然样条函数分析cumUA与baPWV的关系及cumUA对baPWV的影响。结果在观察对象20295名中,随着cumUA的增加,baPWV≥14m/s(动脉硬化判断标准)发生率呈上升趋势,不同cumUA分位组baPWV≥14m/s发生率(依次为53.07%,54.35%,56.42%,58.41%,61.91%)比较差异有统计学意义(χ^2=80.77,P<0.05)。在逐步线性回归分析中,校正其他混杂因素后,结果发现,cumUA与baPWV呈正线性相关(β=0.11,P<0.01)。在多因素Logistic回归分析中,校正其他混杂因素后,结果显示,cumUA第3、4、5分位组与第1分位组比较≥14m/s的危险因素,OR值(95%CI值)分别为[1.35(1.13,1.62),P=0.01;1.60(1.29,1.97),P<0.01;2.14(1.64,2.80),P<0.01]。自然样条函数分析显示cumUA与baPWV升高呈现类似J形曲线关系。结论cumUA是baPWV升高的危险因素。To investigate the correlation between cumulative serum uric acid (cumUA) and brachial-ankle pulse wave velocity (baPWV).Methods Among the workers who participated in the four health check-up of Kailuan Group from 2010 to 2017,subjects who completed one PWV test were selected.The subjects who met the selection criteria were 20 688,subjects who lacked the first three uric acid tests and sex data were excluded.The subjects who had ischemic stroke (excluding lacunar infarction),transient ischemic attack and myocardial infarction were excluded.Decreased subjects were excluded and the extreme value were also excluded,20 295 subjects eventually meet the inclusion criteria and were included for statistical analysis.Stepwise linear regression,multivariate logistic regression and natural spline function were used to analyze the relationship between cumUA and baPWV and the influence of cumUA on baPWV.Results Among 20 295 subjects,the incidence of baPWV≥14 m/s(criteria for judging atherosclerosis) increased with the increase of cumUA.There was significant difference in the incidence of baPWV≥14 m/s (53.07%,54.35%,56.42%,58.41%,61.91%) among different cumUA partition groups (β=0.11,P<0.01).In stepwise linear regression analysis,after adjusting for other confounding factors,it was found that cumUA was positively correlated with baPWV.In multivariate logistic regression analysis,after adjusting for other confounding factors,the results showed that baPWV≥aPWVm were all risk factors for the third,fourth and fifth subgroups of cumUA compared with the first subgroup,and the OR(95%CI) was 1.35(1.13,1.62)(P=0.01),1.60(1.29,1.97)(P<0.01) and 2.14(1.64,2.80)(P<0.01),respectively.Natural spline analysis exhibited a similar J curve relationship between cumUA and increased baPWV.Conclusion CumUA is a risk factor for increased baPWV.

关 键 词：尿酸 脉搏波分析 

分 类 号：R446[医药卫生—诊断学]