264例痛风患者合并肾功能不全的危险因素分析  

Risk Factors for Renal Insufficiency in 264 Patients with Gout

作　　者：聂沛盈 李倩[1] 顾冰洁[1] 任启洁[1] 陈兴国[1] NIE Peiying;LI Qian;GU Bingjie;REN Qijie;CHEN Xingguo(Department of Rheumatology and Immunology,Nanjing Frist Hospital,Nanjing Medical U niversity,Nanjing 210006,China)

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)风湿免疫科,江苏南京210006

出　　处：《标记免疫分析与临床》2025年第1期43-51,共9页Labeled Immunoassays and Clinical Medicine

基　　金：南京市卫生科技发展专项资金项目(编号:YKK19075)。

摘　　要：目的 回顾性分析住院痛风患者的临床资料,分析痛风患者的发病特点,探讨肾功能不全的相关危险因素,为痛风患者的临床治疗及疾病管理提供临床依据。方法 收集2021年7月至2024年3月于南京市第一医院风湿免疫科住院部就诊的264例痛风患者的人口学信息、既往病史、实验室指标及影像学检查等资料。(1)对痛风患者一般资料进行描述分析;(2)根据eGFR分为肾功能不全组(203例)和肾功能正常组(61例),分析两组临床资料及相关指标的差异,评估痛风合并肾功能不全的影响因素;(3)根据eGFR分为CKD1、CKD2、CKD3、CKD4~5期4组患者,评估不同等级肾功能不全的痛风患者间的影响因素差异。结果 (1)本研究共收集痛风患者264例,男性227例,占86.0%,女性37例,占14.0%。痛风患者中平均年龄为65.8䥺SymbolqB@15.9岁,平均病程为6.5䥺SymbolqB@7.8年。痛风患者合并高血压病、糖尿病、冠心病、高脂血症、脂肪肝、肾结石、肾功能不全、吸烟史、饮酒史、超重或肥胖分别为70.1%、27.7%、15.9%、62.9%、33.7%、23.5%、76.9%、26.1%、15.5%、75.4%。(2)肾功能不全组和肾功能正常组在高血压病、糖尿病、冠心病、HB、AST、FBG、TC、TG、LDL-C、ESR、CRP方面差异有统计学意义(P<0.05),在年龄、性别构成、BMI、SBP、DBP、吸烟史、饮酒史、病程、肾结石、痛风石、WBC、PLT、ALT、HbA1c、Cys-C、BUN、SUA、HDL-C方面差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,高血压病(OR=5.477,95%CI:2.687~11.163,P<0.001)、冠心病(OR=11.268,95%CI:1.367~92.854,P=0.024)、低HB(OR=0.978,95%CI:0.958~0.998,P=0.029)、高CRP(OR=1.012,95%CI:1.003~1.021,P=0.013)是痛风患者发生肾功能不全的影响因素。(3)CKD1、2、3、4组在高血压、糖尿病、冠心病、痛风石、ALT、AST、FBG、SUA、TC、TG、LDL-C、ESR、CRP方面差异有统计学意义(P<0.05),在年龄、性别、BMI、SBP、DBP、吸烟史、饮酒史、�Objective The clinical data and pathogenesis characteristics of hospitalized patients with gout were retrospectively analyzed,while the risk factors related to renal insufficiency were discussed,so as to provide a clinical basis for the clinical treatment and disease management.Methods The demographic information,past medical history,laboratory indicators and imaging examinations of 264 gout patients who were treated in the Inpatient Department of the Department of Rheumatology and Immunology of Nanjing First Hospital from July,2021 to March,2024 were collected.These patients were divided into four groups according to eGFR,including CKD1,CKD2,CKD3,and CKD4-5 stages,to evaluate the differences in influencing factors among patients with gout with different grades of renal insufficiency.Results(1)A total of 264 gout patients were collected in this study,including 227 males(86.0%)and 37 females(14.0%).The average age was 65.8±15.9 years,and the average disease course was 6.5±7.8 years.The incidence of hypertension,diabetes,coronary heart disease,hyperlipidemia,fatty liver,kidney stones,renal insufficiency,smoking history,drinking history,overweight or obesity were 70.1%,27.7%,15.9%,62.9%,33.7%,23.5%,76.9%,26.1%,15.5%,and 75.4%,respectively.(2)There were statistical differences between the renal insufficiency group and the normal renal function group in hypertension,diabetes,coronary heart disease,HB,AST,FBG,TC,TG,LDL-C,ESR,and CRP(P<0.05),while there were no statistical differences in age,gender composition,BMI,SBP,DBP,smoking history,drinking history,disease course,kidney stones,tophi,WBC,PLT,ALT,HbA1c,Cys-C,BUN,SUA,and HDL-C(P>0.05).Multivariate logistic regression analysis showed that hypertension(OR=5.477,95%CI:2.687-11.163,P<0.001),coronary heart disease(OR=11.268,95%CI:1.367-92.854,P=0.024),low HB(OR=0.978,95%CI:0.958-0.998,P=0.029),and high CRP(OR=1.012,95%CI:1.003-1.021,P=0.013)were the influencing factors for renal insufficiency in gout patients.(3)There were statistical differences among CKD1,2,3,and 4 gr

关 键 词：痛风 肾功能不全 影响因素 

分 类 号：R593.2[医药卫生—内科学]