社区老年人群的血尿酸升高检出与对高尿酸血症的认知情况分析

Analysis of the detection of elevated blood uric acid and the cognition of hyperuricemia in the elderly people in the community

目的:分析社区65岁及以上老年人血尿酸(UA)升高的检出情况和对高尿酸血症(HUA)的认知情况,为进一步开展社区防治提供策略。方法:以参加体检的3597名65岁及以上老年人为研究对象,平均年龄(70.08±5.50)岁。其中男性1652人,女性1945人。分析老年人群血UA升高情况和对HUA、痛风等相关认知情况。结果:65岁及以上老年人的血UA升高的检出率为25.44%;75岁及以上年龄组女性的检出率显著高于同年龄组的男性(P<0.05)。血UA升高组的经常饮酒率高于血UA正常组(14.54%比11.86,P=0.035);超重肥胖、血压升高、血脂异常、血肌酐升高、尿素氮升高的检出率也高于血UA正常组,差异均有统计学意义(P<0.05)。两组空腹血糖升高的检出率差异无统计学意义(P>0.05)。在915名血UA升高检出者中有232人知晓自身患有HUA。183名有过痛风发作的患者中,首次发作<65岁者占62.30%,首次发作大脚趾关节者占74.86%,每年痛风发作≥3次者占66.12%,曾发现有肾结石者占53.55%,知晓血UA控制指标者占13.11%,知晓急性痛风发作期间是否能服用降尿酸药物者占7.10%,急性痛风发作期间是否需要多喝水者占78.69%,知晓急性痛风发作期间饮食注意事项者占41.53%。结论:社区老年人血UA升高检出率较高,基层医疗机构在对社区老年人血UA的健康管理方面存在不足,社区老年人对HUA和痛风的认识还存在着较大的问题。应依托区域医疗联合体或医疗中心的资源优势,积极探索分级诊疗模式下的社区老年人群血UA的管理。

Objective:To analyze the detection of elevated blood uric acid(UA)and the cognition of hyperuricemia(HUA)in the elderly people aged 65 years and above in the community,so as to provide strategies for further community prevention and control.Methods:Three thousand five hundred and ninety-seven elderly people aged 65 and above who participated in the physical examination were selected as the research objects,with an average age of(70.08±5.50)years old,among them there were 1652 males and 1945 females.The elevated blood UA,the related cognition of HUA and gout in the elderly were analyzed.Results:The detection rate of elevated blood UA in the elderly 65 years and older was 25.44%;the detection rate of women in the age group of 75 years and above was significantly higher than that of men in the same age group(P<0.05).The rate of regular alcohol consumption in the elevated blood UA group was higher than that in the normal blood UA group(14.54%vs.11.86,P=0.035);the detection rates in overweight and obesity,elevated blood pressure,dyslipidemia,elevated blood creatinine,and elevated urea nitrogen were also higher than those in normal blood UA group,and the differences were statistically significant(P<0.05).There was no significant difference in the detection rate of elevated fasting blood glucose between the two groups(P>0.05).Among the 915 people who were detected the increase of blood UA,232 people knew that they had hyperuricemia.Among 183 patients who had gout attack,62.30%of them had the first attack under 65 years old,74.86%had the first attack of big toe joint,and 66.12%had gout attack more than 3 times a year,53.55%had kidney stones,13.11%knew the blood UA control indicators,7.10%knew whether to take UA lowering drugs during acute gout attack,whether they needed to drink more water during an acute gout attack accounted for 78.69%,and 41.53%were aware of dietary precautions during acute gout attacks.Conclusion:The detection rate of elevated blood UA in the elderly in the community is relatively high.Primary medical institutions have insufficient health management of blood UA in the elderly in the community,and there are still big problems in the understanding of HUA and gout among the elderly in the community.Relying on the resource advantages of regional medical consortia or medical centers,the management of blood UA among the elderly in the community under the hierarchical diagnosis and treatment mode should be actively explored.