原发性痛风患者脂代谢异常与尿酸结石相关性分析
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摘要
目的对比分析原发性痛风患者脂代谢异常与尿酸结石发生的相关性,为治疗原发性痛风提供理论依据。方法选取2016年1月至2018年1月中南大学湘雅医院和醴陵市中医院治疗的164例原发性痛风患者为研究对象,其中,单纯痛风患者100例,为单纯痛风组,合并尿酸结石患者64例,为合并组。选取同期在中南大学湘雅医院和醴陵市中医院体检结果正常的112例人员为对照组,对三组研究对象进行血液和尿液分析。结果单纯痛风组和合并组患者高密度脂蛋白胆固醇(HDL?C)、血二氧化碳结合力(CO2CP)表达水平低于对照组,载脂蛋白E(ApoE)、血甘油三脂(TG)、尿钙、血尿酸、血磷和血钙表达水平高于对照组,差异有统计学意义(P<0.05),合并组患者体质量指数、尿酸水平、收缩压、TG、空腹血糖、舒张压高于单纯痛风组患者,差异有统计学意义(P<0.05),高体质量指数、高尿酸、高空腹血糖和高脂血症是尿酸结石发生的独立危险因素,差异有统计学意义(P<0.05)。结论尿酸结石患者血脂及电解质表达水平与正常人存在明显差异,高体质量指数、高尿酸、高空腹血糖和高脂血症是尿酸结石发生的危险因素。
Objective The correlation between abnormal lipid metabolism and the occurrence of uric acid stones in patients with primary gout was compared and analyzed to provide a theoretical basis for the treatment of primary gout. Methods A total of 164 patients with primary gout treated by Xiangya Hospital of Central South University and Liling City Hospital of Traditional Chinese Medicine from January 2016 to January 2018 were enrolled;100 patients with gout alone were selected as simple gout group and 64 patients with uric acid stones as the merge group. A total of 112 patients who had normal physical examination results at Xiangya Hospital and Liling City Hospital of Central South University were selected as the control group. Blood and urine analysis were performed. Results The expression levels of high ? density lipoprotein cholesterol(HDL?C)and blood carbondioxide combining power(CO2 CP)in the patients with simple gout and combined group were lower than those in the control group. The expression levels of apolipoprotein E(ApoE),triglyceride(TG),urinary calcium,blood uric acid,serum phosphorus and serum calcium were higher than those in the control group(P<0.05). The combined group body mass index,uric acid level,systolic blood pressure,TG,the fasting blood glucose and diastolic blood pressure were higher than those in the simple gout group. The differences were statistically significant(P<0.05). High body mass index,high uric acid,high fasting blood glucose and hyperlipidemia were independent risk factors for uric acid stones,and the differences were statistically significant(P<0.05). Conclusion The levels of serum lipids and electrolytes in patients with uric acid stones are significantly different from those in normal subjects. High body mass index,high uric acid,high fasting blood glucose and hyperlipidemia are risk factors for uric acid stones.
Objective The correlation between abnormal lipid metabolism and the occurrence of uric acid stones in patients with primary gout was compared and analyzed to provide a theoretical basis for the treatment of primary gout. Methods A total of 164 patients with primary gout treated by Xiangya Hospital of Central South University and Liling City Hospital of Traditional Chinese Medicine from January 2016 to January 2018 were enrolled;100 patients with gout alone were selected as simple gout group and 64 patients with uric acid stones as the merge group. A total of 112 patients who had normal physical examination results at Xiangya Hospital and Liling City Hospital of Central South University were selected as the control group. Blood and urine analysis were performed. Results The expression levels of high ? density lipoprotein cholesterol(HDL?C)and blood carbondioxide combining power(CO2 CP)in the patients with simple gout and combined group were lower than those in the control group. The expression levels of apolipoprotein E(ApoE),triglyceride(TG),urinary calcium,blood uric acid,serum phosphorus and serum calcium were higher than those in the control group(P<0.05). The combined group body mass index,uric acid level,systolic blood pressure,TG,the fasting blood glucose and diastolic blood pressure were higher than those in the simple gout group. The differences were statistically significant(P<0.05). High body mass index,high uric acid,high fasting blood glucose and hyperlipidemia were independent risk factors for uric acid stones,and the differences were statistically significant(P<0.05). Conclusion The levels of serum lipids and electrolytes in patients with uric acid stones are significantly different from those in normal subjects. High body mass index,high uric acid,high fasting blood glucose and hyperlipidemia are risk factors for uric acid stones.
引文
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[2]邓亚娟,张少玲,刘品明,等.原发性醛固酮增多症与原发性高血压患者糖脂代谢异常及尿酸水平的比较[J].中华高血压杂志,2017,25(4):400.
[3]Ankli B,Kyburz D,Hirschmann A,et al.Calcium pyrophosphate deposition disease:a frequent finding in patients with longstanding erosive gout[J].Scand J Rheumatol,2018,47(2):127-130.
[4]杨历浩,李莉,崔天祥,等.原发性高血压患者晨峰血压与血尿酸的相关性[J].中国老年学杂志,2017,37(7):1628-1630.
[5]应颖,黄海燕,邹荣鑫,等.尿酸转运蛋白相关基因多态性与原发性痛风遗传易感性关系的荟萃分析[J].浙江医学,2017,39(20):1763-1770,1777.
[6]Muangchan C,Bhurihirun T.An investigation of the independent risk factors that differentiate gout from pseudogout in patients with crystal-induced acute arthritis:a cross-sectional study[J].Rheumatol Int,2018,38(1):89-95.
[7]甘浪,潘书光,崔劲驰,等.ABCB11基因变异与原发性肝内胆管结石的相关性研究[J].中华消化外科杂志,2017,16(4):410-416.
[8]巴兰坦.临床血脂学:Braunwald心脏病学姊妹卷[M].北京:北京大学医学出版社,2011.
[9]胡向阳,刘桃丽,林春淑,等.广东三丫苦叶膜分离提取物对原发性高尿酸血症患者降尿酸疗效观察[J].中国中西医结合杂志,2017,37(5):626-628.
[10]Yin R,Cao H,Fu T,et al.The rate of adherence to uratelowering therapy and associated factors in Chinese gout patients:a cross-sectional study[J].Rheumatology International,2017,37(7):1187-1194.
[11]唐振柱,陈玉柱,吴兴华,等.痛风病人同型半胱氨酸和炎症指标的病例对照研究[J].中国热带医学,2016,16(12):1198-1203.
[12]李小华,周志宏,邢波,等.血清尿酸水平与早发性冠状动脉疾病患者心血管风险相关性分析[J].热带医学杂志,2015,15(8):1079-1082.
[13]刘敏华.阿托伐他汀联合依折麦布对CHD患者血脂及血清CRP的影响[J].热带医学杂志,2016,16(2):217-220.
[14]丁存涛,李静,朱玮玮,等.红细胞分布宽度与原发性高血压患者高尿酸血症的相关性[J].山西医科大学学报,2017,48(1):6-10.
[15]Janssen CA,Jansen TLTA,Oude Voshaar MAH,et al.Quality of care in gout:a clinical audit on treating to the target with urate lowering therapy in real-world gout patients[J].Rheumatol Int,2017,37(9):1435-1440.
[16]蒋立,罗生军,杨磊,等.输尿管软镜碎石术后SIRS发生与结石成分的相关性分析[J].重庆医学,2017,46(25):3489-3490.