摘要
目的 探讨不同年龄高尿酸血症患者临床特征及其发病影响因素.方法 回顾性选取2020年7月至2023年7月兵器工业五二一医院收治的249例高尿酸血症患者作为研究对象,将其分为高尿酸血症组,依照患者年龄将其分为3组,20～44岁为Ⅰ组(n=104),45～59岁为Ⅱ组(n=80),60岁及以上为Ⅲ组(n=65).对比Ⅰ组、Ⅱ组、Ⅲ组的临床症状(无症状性高尿酸血症、痛风性关节炎、痛风石形成、关节畸形、尿酸性尿路结石)、合并症(脑梗死、冠心病、慢性肾脏病、糖尿病、高血压、高脂血症)情况和血尿酸、血肌酐、血尿素氮、胱抑素C、甘油三酯、总胆固醇相关实验室指标水平的差异.另选取同期来本院体检的200名健康者作为非高尿酸血症组,分析高尿酸血症的单因素,并应用Lo-gistic回归分析法分析高尿酸血症发生的独立危险因素.结果 Ⅲ组患者无症状性高尿酸血症和痛风性关节炎发生率均低于Ⅰ组和Ⅱ组,Ⅲ组患者痛风石形成、关节畸形、尿酸性尿路结石情况发生率高于Ⅰ组和Ⅱ组.3组患者高脂血症发生率比较,差异无统计学意义(P＞0.05),Ⅲ组合并症发生率明显高于Ⅰ组和Ⅱ组,但Ⅱ组患者糖尿病发生率高于Ⅰ组和Ⅲ组,差异均有统计学意义(P＜0.05).3组患者的血尿酸表达水平比较,差异无统计学意义(P＞0.05),Ⅲ组患者血肌酐、血尿素氮、胱抑素C水平高于Ⅰ组和Ⅱ组,Ⅰ组患者甘油三酯、总胆固醇水平均高于Ⅱ组和Ⅲ组,差异均有统计学意义(P＜0.05).非高尿酸血症组和高尿酸血症组患者年龄比较,差异无统计学意义(P＞0.05),非高尿酸血症组和高尿酸血症组患者性别、体重指数、合并高血压、合并高脂血症、合并糖尿病、饮酒史、吸烟史、运动情况、文化程度、合并肾功能异常以及血尿酸水平比较,差异均有统计学意义(P＜0.05).Logistic回归分析结果表明:体重指数升高、合并高血压、合并高脂血症、合并糖尿病、合并肾功能异常以及血尿酸水平升高均为高尿酸血症的独立危险因素(P＜0.05).结论 不同年龄高尿酸血症患者临床特征具有显著差异,低年龄的高尿酸血症患者多以无症状性高尿酸血症和痛风性关节炎为主,高年龄患者多出现痛风石形成、关节畸形、尿酸性尿路结石情况,且多合并多种基础疾病.另外,血尿酸水平升高为高尿酸血症的基本特征,体重指数升高、合并高血压、合并高脂血症、合并糖尿病、合并肾功能异常为高尿酸血症发生的独立危险因素.
Abstract
Objective To investigate the clinical characteristics and influencing factors of hyperuricemia in patients of different ages.Methods A total of 249 patients with hyperuricemia in 521 Hospital of Norinco Group from July 2020 to July 2023 were selected as the research object and divided into the hyperuricemia group.According to the age of patients,they were divided into three groups,20-44 years old as groupⅠ(n=104),45-59 years old as group Ⅱ(n=80),and 60 years old and above as group Ⅲ(n=65).The clinical symptoms(asymptomatic hyperuricemia,gouty arthritis,formation of gouty stones,joint deformities,and uric acid urinary calculi),complications(cerebral infarction,cor-onary heart disease,chronic kidney disease,diabetes,hypertension,hyperlipidemia),and the levels of serum uric acid,serum creatinine,blood urea nitrogen,Cystatin C,triglyceride,and total cholesterol were compared.Another 200 healthy people who came to our hospital for physical ex-amination in the same period were selected as the non hyperuricemia group.The single factor of hyperuricemia was analyzed,and the independent risk factors of hyperuricemia were analyzed by Logistic regression analysis.Results The incidence of asymptomatic hyperuricemia and gouty ar-thritis in group Ⅲ was lower than that in group Ⅰ and group Ⅱ,and the incidence of formation of gouty stones,joint deformity and uric acid uri-nary calculi in group Ⅲ was higher than that in group Ⅰ and group Ⅱ,the differences were statistically significant(P＜0.05).There was no statistically significant difference in the incidence of hyperlipidemia among the three groups(P＞0.05).The incidence of complications in group Ⅲ was higher than that in group Ⅰ and group Ⅱ,but the incidence of diabetes in group Ⅱ was higher than that in group Ⅰ and group Ⅲ,the differences were statistically significant(P＜0.05).The levels of serum creatinine,blood urea nitrogen and cystatin C in group Ⅲ were higher than those in group Ⅰ and group Ⅱ,and the levels of triglyceride and total cholesterol in group Ⅰ were higher than those in group Ⅱ and groupⅢ,the differences were statistically significant(P＜0.05).There was no statistically significant difference in age between the non hyperuricemia group and the hyperuricemia group(P＞0.05),there were statistically significant differences in gender,body mass index,hypertension,hyper-lipidemia,diabetes,drinking history,smoking history,exercise,education level,renal dysfunction and serum uric acid level between the non hy-peruricemia group and the hyperuricemia group(P＜0.05).Logistic regression analysis showed that body mass index,hypertension,hyperlipi-demia,diabetes,abnormal renal function and elevated serum uric acid levels were independent risk factors for hyperuricemia(P＜0.05).Conclu-sion The clinical characteristics of patients with hyperuricemia at different ages have significant differences.Patients with hyperuricemia at low a-ges are mainly asymptomatic hyperuricemia and gouty arthritis.Patients with high ages are more likely to have gout stone formation,joint deformi-ty,uric acid urinary calculi,and are more likely to be complicated with a variety of basic diseases.In addition,the increase of serum uric acid level is the basic feature of hyperuricemia,and the increase of body mass index,hypertension,hyperlipidemia,diabetes and renal dysfunction are the independent risk factors of hyperuricemia.
维普
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