急性痛风性关节炎患者肝损伤临床特征及影响因素分析  

Clinical characteristics and influencing factors of liver injury in patients with acute gouty arthritis

作　　者：沈扬[1] 孙伯坚[1] 赵丹[1] 尹婉宜[1] 刘清池[1] SHEN Yang;SUN Bojian;ZHAO Dan;YIN Wanyi;LIU Qingchi(Department of Hematology,the First Hospital of Hebei Medical University,Shijiazhuang,Hebei 050031,China)

机构地区：[1]河北医科大学第一医院血液内科,河北石家庄050031

出　　处：《现代医药卫生》2022年第9期1468-1471,1475,共5页Journal of Modern Medicine & Health

基　　金：河北省卫生健康委员会医学科学研究项目(20150655)。

摘　　要：目的探讨急性痛风性关节炎患者肝损伤临床特征及其影响因素。方法收集2016年3月至2018年2月该院门诊收治的92例急性痛风性关节炎患者作为痛风组,同时选取血尿酸水平在正常范围的体检者79例作为对照组。根据肝损伤发生情况进一步将观察组分为肝损伤组和非肝损伤组。比较各组空腹血糖(FBG)、尿酸、甘油三酯(TG)、总胆固醇(TC)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、碱性磷酸酶(ALP)、总胆红素(TBIL)、总胆汁酸(TBA)等指标变化情况,分析急性痛风性关节炎患者肝损伤的影响因素。结果痛风组、对照组尿酸、TG、ALT、AST、TBA水平比较,差异有统计学意义(P<0.001);而FBG、TC、ALP、TBIL水平比较,差异无统计学意义(P>0.05)。年龄、疼痛关节数量是尿酸水平的影响因素(P<0.05)。痛风组、对照组ALT、AST水平异常及肝损伤发生率方面比较,差异有统计学意义(P<0.05);而ALP、TBIL水平异常发生率比较,差异无统计学意义(P>0.05)。年龄、患病时间、疼痛关节数量及FBG、尿酸、TG、TC水平不是急性痛风性关节炎患者肝损伤的影响因素(P>0.05)。AST、TBA水平是急性痛风性关节炎患者ALT水平的影响因素(P<0.001);ALT、TBA、TG水平是急性痛风性关节炎患者AST水平的影响因素(P<0.001)。结论ALT是反映急性痛风性关节炎合并肝损伤的敏感性指标。对于急性痛风性关节炎患者,临床医生应全面评估,尽量避免使用可引起肝损伤的药物。Objective To investigate the clinical characteristics and influencing factors of liver injury in patients with acute gouty arthritis.Methods 92 patients with acute gouty arthritis treated in the outpatient department of the hospital from March 2016 to February 2018 were collected as the gout group,and 79 physical examiners with normal blood uric acid level were selected as the control group.According to the occurrence of liver injury,the observation group was further divided into liver injury group and non liver injury group.The changes of fasting blood glucose(FBG),uric acid,triglyceride(TG),total cholesterol(TC),alanine aminotransferase(ALT),aspartate aminotransferase(AST),alkaline phosphatase(ALP),total bilirubin(TBIL)and total bile acid(TBA)in each group were compared,and the influencing factors of liver injury in patients with acute gouty arthritis were analyzed.Results The levels of uric acid,TG,ALT,AST and TBA were significantly different(P<0.001),and there were no significant differences in the levels of FBG,TC,ALP and TBIL in the gout group and the control group(P>0.05).The age,pain and the number of joints were the influencing factors of uric acid level(P<0.05).There were significant differences in the incidence of abnormal ALT,AST levels and liver injury(P<0.05),and there were no significant differences in the incidence of abnormal ALP and TBIL levels between the gout group and the control group(P>0.05).The age,time of onset,number of painful joints and the levels of FBG,uric acid,TG and TC were not the influencing factors of liver injury in patients with acute gouty arthritis(P>0.05).The levels of AST and TBA were the influencing factors of ALT level in patients with acute gouty arthritis(P<0.001),the levels of ALT,TBA and TG were the influ-encing factors of AST level in patients with acute gouty arthritis(P<0.001).Conclusion ALT is a sensitive index reflecting acute gouty arthritis complicated with liver injury.For patients with acute gouty arthritis,cli-nicians should comprehensively evaluate and tr

关 键 词：急性痛风性关节炎 高脂血症 尿酸 肝功能 

分 类 号：R589.7[医药卫生—内分泌]