湖南省长沙市痛风患者危险因素流行病学调查
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摘要
目的 调查湖南省长沙市痛风患者的危险因素特点,为痛风的临床防治提供科学依据。方法 随机选择2017年7月-2018年10月湘雅医院风湿免疫科确诊的长沙市痛风患者102例(痛风组)及湘雅医院就诊的长沙市非痛风患者105例(对照组)为研究对象,进行问卷调查,用单因素和多因素方法分析各因素与痛风发病的相关性。结果 痛风组、对照组的男女性别构成(男性:95.10%vs.42.86%)、年龄[(46.02±14.49)岁vs.(36.88±13.40)岁]、BMI[(24.70±0.28)kg/m~2vs.(22.95±0.46)kg/m~2]、劳动强度构成(较大强度:54.90%vs.7.62%)、饮白酒史占比(52.94%vs.14.29%)、吸烟史占比(36.28%vs.15.24%)、高血压史占比(28.43%vs.8.57%)、高血脂史占比(42.16%vs.9.52%)、肾脏疾病史占比(21.57%vs.1.91%),差异有统计学意义(P<0.05)。以是否患痛风为因变量的多因素非条件logistic回归分析表明,男性(OR=6.245,95%CI:1.647～23.669)、饮白酒史(OR=2.404,95%CI:1.231～7.039)、肾脏疾病史(OR=12.669,95%CI:1.609～99.737)、劳动强度较大(OR=4.415,95%CI:1.605～12.148)是痛风发病的独立危险因素。结论 男性、高龄、BMI高、劳动强度较大、饮白酒、吸烟,以及有高血压、高血脂、肾脏疾病史者需高度警惕痛风的发生。
Objective To survey the characteristics of risk factors for gout patients in Changsha city, Hunan province, and to provide a scientific basis for clinical prevention and treatment of gout. Methods We randomly selected 102 gout patients(the gout group) and 105 non-gout patients(the control group) confirmed by Rheumatology and Immunology Department of Xiangya Hospital in Changsha city from July 2017 to October 2018 to serve as the research subjects. Questionnaire surveys were conducted, and then single factor and multiple factor analyses were performed to identify the correlation between each factor and pathogenesis of gout. Results There were statistically significant differences in the constituent ratio of male and female(male: 95.10% vs. 42.86%), age((46.02±14.49) years old vs.(36.88±13.40) years old), body mass index((24.70±0.28) kg/m~2 vs.(22.95±0.46) kg/m~2), the constituent ratio of labor intensity(high labor intensity: 54.90% vs. 7.62%), the proportion of history of drinking(52.94% vs. 14.29%), the proportion of history of smoking(36.28% vs. 15.24%), the proportion of history of hypertension(28.43% vs. 8.57%), the proportion of history of hyperlipoidemia(42.16% vs. 9.52%) and the proportion of history of kidney diseases(21.57% vs. 1.91%) between the gout group and the control group(all P<0.05). Multi-factor unconditional logistic regression analysis based on considering whether suffering gout as a dependent variable indicated that male(OR=6.245, 95%CI:1.647-23.669), history of drinking(OR=2.404, 95%CI:1.231-7.039), history of kidney diseases(OR=12.669, 95%CI:1.609-99.737) and high labor intensity(OR=4.415, 95%CI:1.605-12.148) were independent risk factors for gout. Conclusions It is very important for the male, the elderly, the obese, workers with high labor intensity, drinkers, smokers and people with history of hypertension, hyperlipidemia and kidney diseases to maintain strict and constant vigilance over gout.
Objective To survey the characteristics of risk factors for gout patients in Changsha city, Hunan province, and to provide a scientific basis for clinical prevention and treatment of gout. Methods We randomly selected 102 gout patients(the gout group) and 105 non-gout patients(the control group) confirmed by Rheumatology and Immunology Department of Xiangya Hospital in Changsha city from July 2017 to October 2018 to serve as the research subjects. Questionnaire surveys were conducted, and then single factor and multiple factor analyses were performed to identify the correlation between each factor and pathogenesis of gout. Results There were statistically significant differences in the constituent ratio of male and female(male: 95.10% vs. 42.86%), age((46.02±14.49) years old vs.(36.88±13.40) years old), body mass index((24.70±0.28) kg/m~2 vs.(22.95±0.46) kg/m~2), the constituent ratio of labor intensity(high labor intensity: 54.90% vs. 7.62%), the proportion of history of drinking(52.94% vs. 14.29%), the proportion of history of smoking(36.28% vs. 15.24%), the proportion of history of hypertension(28.43% vs. 8.57%), the proportion of history of hyperlipoidemia(42.16% vs. 9.52%) and the proportion of history of kidney diseases(21.57% vs. 1.91%) between the gout group and the control group(all P<0.05). Multi-factor unconditional logistic regression analysis based on considering whether suffering gout as a dependent variable indicated that male(OR=6.245, 95%CI:1.647-23.669), history of drinking(OR=2.404, 95%CI:1.231-7.039), history of kidney diseases(OR=12.669, 95%CI:1.609-99.737) and high labor intensity(OR=4.415, 95%CI:1.605-12.148) were independent risk factors for gout. Conclusions It is very important for the male, the elderly, the obese, workers with high labor intensity, drinkers, smokers and people with history of hypertension, hyperlipidemia and kidney diseases to maintain strict and constant vigilance over gout.
引文
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[12] 王颜刚,阎胜利,李长贵,等.原发性高尿酸血症患者发生痛风的前瞻性研究[J].中华内分泌代谢杂志,2011,27(7):553-556.
[13] 刘晓琳,周弋,阮晓楠,等.上海市浦东新区慢性肾病流行情况及其危险因素研究[J].中国全科医学,2016,19(30):3742-3750.
[14] 黄彦弘,吕艳伟,李东,等.痛风的临床危险因素logistic研究[J].中国全科医学,2010,13(1):52-53,56.
[15] 刘晶.痛风的临床危险因素研究[J].中国实用医药,2017,12(32):82-83.
[16] 王靖宇,常宝成.高尿酸血症/痛风流行病学特点及危险因素[J].国际内分泌代谢杂志,2016,36(2):78-81,88.
[2] 曾学军.《2010年中国痛风临床诊治指南》解读[J].中国实用内科杂志,2012,32(6):438-441.
[3] Krishnan E,Akhras KS,Sharma H,et al.Relative and attributable diabetes risk associated with hyperuricemia in US veterans with gout[J].QJM,2013,106(8):721-729.
[4] Bove M,Cicero AF,Veronesi M,et al.An evidence-based review on urate-lowering treatments:implications for optimal treatment of chronic hyperuricemia[J].Vasc Health Risk Manag,2017,13:23-28.
[5] Robinson PC,Taylor WJ,Merriman TR.Systematic review of the prevalence of gout and hyperuricaemia in Australia[J].Intern Med J,2012,42(9):997-1007.
[6] Trifirò G,Morabito P,Cavagna L,et al.Epidemiology of gout and hyperuricaemia in Italy during the years 2005-2009:a nationwide population-based study[J].Ann Rheum Dis,2013,72(5):694-700.
[7] 余俊文,杨同广,刁伟霞,等.广东省佛山市居民高尿酸血症及痛风的流行病学调查[J].中华流行病学杂志,2010,31(8):860-862.
[8] 方卫纲,黄晓明,王玉,等.高尿酸血症在北京地区1 997人中的患病情况及相关因素分析[J].中华医学杂志,2006,(25):1764-1768.
[9] 范江华,范江诺,张学顺,等.痛风发生因素分析与预防对策[J].中国医学创新,2011,8(6):18-20.
[10] 申志祥,郑卉,殷钢,等.老年体检人群心脑血管疾病患者健康状况综合评估[J].实用预防医学,2018,25(8):905-910.
[11] 马利丹,孙瑞霞,辛颖,等.不同体重指数痛风患者临床特点分析[J].中华内科杂志,2017,56(5):353-357.
[12] 王颜刚,阎胜利,李长贵,等.原发性高尿酸血症患者发生痛风的前瞻性研究[J].中华内分泌代谢杂志,2011,27(7):553-556.
[13] 刘晓琳,周弋,阮晓楠,等.上海市浦东新区慢性肾病流行情况及其危险因素研究[J].中国全科医学,2016,19(30):3742-3750.
[14] 黄彦弘,吕艳伟,李东,等.痛风的临床危险因素logistic研究[J].中国全科医学,2010,13(1):52-53,56.
[15] 刘晶.痛风的临床危险因素研究[J].中国实用医药,2017,12(32):82-83.
[16] 王靖宇,常宝成.高尿酸血症/痛风流行病学特点及危险因素[J].国际内分泌代谢杂志,2016,36(2):78-81,88.