吡嗪酰胺相关高尿酸血症患者血尿酸升高程度的影响因素分析  

Analysis of Influencing Factors of the Degree of Increase in Serum Uric Acid in Patients with Pyrazinamide-related Hyperuricemia

作　　者：刘硕[1] 康万里 许瑞[1] 张静[1] 毛欣丰 程凯 Liu Shuo;Kang Wanli;Xu Rui;Zhang Jing;Mao Xinfeng;Cheng Kai(Deptartment of Pharmacy,Beijing Chest Hospital,Capital Medical University,Beijing 101149,China)

机构地区：[1]首都医科大学附属北京胸科医院药学部,北京101149 [2]首都医科大学附属北京胸科医院流行病学研究室,北京101149

出　　处：《结核病与胸部肿瘤》2021年第1期38-42,共5页Tuberculosis and Thoracic Tumor

摘　　要：目的分析吡嗪酰胺相关高尿酸血症(HUA)患者血尿酸升高程度的影响因素。方法检索国家药品不良反应监测信息网络系统,收集首都医科大学附属北京胸科医院2012年1月至2019年6月上报的吡嗪酰胺致HUA不良反应报告,记录患者性别、年龄、身高、体重、药物过敏史、抗结核治疗方案、服用吡嗪酰胺时间和用药前后血尿酸水平等信息,采用线性回归方法分析上述因素对血尿酸升高程度的影响。血尿酸升高程度以血尿酸变化率表示。结果纳入分析的患者共177例,男性124例,女性53例;年龄15~82岁,中位年龄33(23,54)岁;体重(60±12)kg,<50 kg者34例(19.2%),50-75 kg者123例(69.5%),>75 kg者20例(11.3%);身高(170±8)cm;使用一线抗结核治疗方案者143例(80.8%),二线方案者34例(19.2%);服用吡嗪酰胺时间为1~97 d,中位时间8(6,11)d;有药物过敏史者33例(18.6%);服用吡嗪酰胺前血尿酸水平为(288±72)umol/L,发生HUA时血尿酸水平为(640±105)umol/L,血尿酸变化率为(139±82)%。单因素线性回归分析结果显示体重与血尿酸变化率呈负相关(r=-1.343,t=-2.660,P=0.009)。不同体重组患者血尿酸变化率的差异有统计学意义(χ^(2)=6.977,P=0.031),<50 kg组和>75 kg组间血尿酸变化率的差异有统计学意义(Z=-2.544,F=0.011)。结论体重是吡嗪酰胺相关HUA患者血尿酸升高程度的独立影响因素。体重较低的HUA患者血尿酸变化率较高。Objective To analyze the influencing factors of the degree of increase in serum uric in patients with hyperuricemia related to pyrazinamide.Methods The National ADR Monitoring Information Network System was searched and the adverse reaction reports of hyperuricemia induced by pyrazinamide that were reported from January 2012 to June 2019 in Beijing Chest Hospital,Capital Medical University were collected.The patients'gendei;age,height,weight,histoiy of drug alleig antituberculosis therapy,time of pyrazinamide treatment,and serum uric acid level before and after the treatment were recorded.Linear regression method was used to analyze the influence of the above factors on the degree of increase in serum uri acidl,which was expressed by the change rate of scerum uric acid.Results A total of 17 patients were enrolled in the study,,including 124 males and 53 females:their ages were from 15 to 82 years,with a median age of 33(23,54)years:their body weight was(60±12)kg.in which 34 cases(19.2%)were<50 kg,123 cases(69.5%)were 50-75 kg,and 20 cases(11.3%)were>75 kg;their height was(170±8)cm.Among the 177 patients,43cases(810.8%)received firt-line rgimen and 34 cases(19.2%)received second-ine regiment;the time of pyrainamide treatment was 1 to 97 days,with a median time of 8(6,11)days,33 cases(18.6%)had history of drug allrgy.The baseline uric acid level in 177 patients was(288±72)μmol/L before pyrazinamide administration and(640±105)μmol/L when hyeruricemis occurred.The change rate of serum uric acid was(139±82)%.Univariatelinear regression analysis showed that body weight was negatively correlted with the change rate of serum uric acid(r=-1.343,t=-2.660,P=0.009).The difference in the change rate of serum uric anid among patients with diferent body weight was statistically significant(χ^(2)=6.977,P=0.031).Thediference in the change rate of serum uric acid between the<50 kg group and the>75 kg group was statistically significant(Z=-2.544,P=0.011).Conclsions Bodly weight is an independent influencing factor for the d

关 键 词：结核 吡嗪酰胺 高尿酸血症 因素分析 统计学 药物相关副作用和不良反应 

分 类 号：R58[医药卫生—内分泌]