系统性红斑狼疮患者血尿酸水平与臂踝动脉脉搏波传导速度的相关性研究  

Study on correlation between serum uric acid level and brachial ankle pulse wave velocity in patients with systemic lupus erythematosus

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

机构地区：[1]开滦总医院风湿免疫科,河北省唐山市063000

出　　处：《中国综合临床》2019年第4期311-316,共6页Clinical Medicine of China

基　　金：河北省医学科学研究重点课题(20181447).

摘　　要：目的探讨系统性红斑狼疮(systemic lupus erythematosus,SLE)、狼疮性肾炎(lupus nephritis,LN)患者血尿酸(uric acid,UA)水平与臂踝动脉脉搏波传导速度(brachial-ankle pulse wave velocity,baPWV)的关系。方法选取2017年1月至2017年9月在开滦总医院住院、门诊及健康体检者,共110例。将其分为3组:(1)同期体检的健康对照组55名,经体检除外既往有高血压病、心肌梗死、卒中病史者。(2)SLE无LN组34例,病例诊断均符合1997年美国风湿病学会(ACR)修订的SLE分类标准,并除外合并狼疮肾炎者。(3)SLE合并LN组21例,病例诊断均符合1997年美国风湿病学会(ACR)修订的SLE分类标准。采用Pearson相关系数及多因素线性回归模型分析影响baPWV的相关因素。结果SLE无LN组和SLE合并LN组baPWV水平和baPWV≥1 400 cm/s的占比均高于健康对照组(P均<0.05)。SLE无LN组中baPWV与年龄、收缩压(systolic blood pressure,SBP)、总胆固醇(total cholesterol,TC)呈正相关(r值分别为0.623、0.528、0.402,P<0.01或P<0.05);与血尿酸(blood uric acid,UA)呈负相关(r=-0.371,P<0.05),但相关性不大,经偏相关分析校正年龄、SBP、舒张压(diastolic blood pressure,DBP)等,UA与baPWV相关性消失。SLE合并LN组中baPWV与SBP、DBP、肌酐(serum creatinine,Cr)呈正相关(r值分别为0.815、0.725、0.464,P<0.01或P<0.05)。多元逐步回归分析结果显示:SLE组SBP与baPWV呈独立相关(t=2.54,P=0.026);SLE无LN组UA与baPWV呈独立负相关(t=-2.96,P=0.042);SLE合并LN组UA(t=4.24,P=0.013)、SBP(t=7.70,P=0.002)与baPWV均呈独立正相关。logistic回归分析显示:SLE为baPWV≥1 400 cm/s的危险因素,其OR(95%CI)为4.31(1.56-11.88),P=0.005且校正年龄、SBP、DBP、体质量指数(body mass index,BMI)等因素后仍有统计学意义。然而SLE无LN组以及SLE合并LN组中,UA并非baPWV≥1 400 cm/s的危险因素(P值分别为0.163、0.519)。结论SLE患者动脉硬化程度高于正常人群,SLE患者UA水平可能与baPWV相关。Objective To investigate the relationship between serum uric acid(UA)level and brachial-ankle pulse wave velocity(baPWV)in patients with systemic lupus erythematosus(SLE)and lupus nephritis(LN).Methods A total of 110 hospitalized,out-patient and healthy examinees from January 2017 to September 2017 were selected from Kailuan General Hospital.They were divided into three groups:(1)Fifty-five healthy controls were examined at the same time,and those who had no history of hypertension,myocardial infarction and stroke were excluded by physical examination.(2)Thirty-four SLE patients without LN were diagnosed according to the SLE classification standard revised by the American Society of Rheumatology(ACR)in 1997,excluding those with lupus nephritis.(3)21 SLE patients with LN were diagnosed according to the SLE classification standard revised by the American Society of Rheumatology(ACR)in 1997.Pearson correlation coefficient and multivariate linear regression model were used to analyze the related factors affecting baPWV.Results The level of baPWV and the proportion of baPWV(≥1400 cm/s)in SLE without LN group and SLE with LN group were higher than those in healthy control group(all P<0.05).In SLE without LN group,baPWV was positively correlated with age,systolic blood pressure(SBP)and total cholesterol(CHOL)(r=0.623,0.528,0.402,P<0.01 or P<0.05),and negatively correlated with blood uric acid(UA)(r=-0.371,P<0.05),but the correlation was not significant.The correlation between UA and baPWV disappeared after after correction of age,SBP,diastolic blood pressure(DBP)by partial correlation analysis.In SLE with LN group,baPWV was positively correlated with SBP,DBP and serum creatinine(Cr)(r=0.815,0.725,0.464,P<0.01 or P<0.05).Multivariate stepwise regression analysis showed that SBP was independently correlated with baPWV in SLE group(t=2.54,P=0.026);UA in SLE group without LN was independently negatively correlated with baPWV(t=-2.96,P=0.042);UA(t=4.24,P=0.013)and SBP(t=7.70,P=0.002)were independently positively correlated

关 键 词：系统性红斑狼疮 狼疮性肾炎 血尿酸 臂踝动脉脉搏波传导速度 

分 类 号：R593.241[医药卫生—内科学]