老年高血压与高尿酸血症

Relationship of Hyperuricemia to Senile Hypertension

目的通过检测老年高血压患者血尿酸(UA)水平,探讨高尿酸血症与老年高血压及并发疾病的关系以及检测血清UA的临床价值。方法血UA采用尿酸酶法测定。对90例老年高血压患者(58例无并发症;32例有并发症,并发症为肾脏、心血管、脑疾病)和50例健康老年人取肘静脉血检测UA水平。结果1老年高血压组血清UA水平显著高于健康对照组(P<0.01);有、无并发症老年高血压患者血清UA水平差异显著(P<0.01)。2阳性率为41.1%(37/90),并发症组阳性率为65.6%(21/32),无并发症组阳性率为27.6%(16/58)。有、无并发症组阳性率差异显著(χ2=12.325,(P<0.01)。阳性预测值56.8%(21/37),阴性预测值72.4%(42/58),敏感性65.6%(21/32),特异性72.4%(42/58),准确度70%(63/90)。3在ROC曲线上,临床的最佳临界值(Cutoffpoint)为390.0μmol/L。敏感性为78.1%(25/32),特异性为67.2%(39/58),阳性预测值为56.8%(25/44),阴性预测值67.2%(39/58),准确度71.1%(64/90)。结论老年高血压患者病情与血清UA水平相关,UA定量测定对老年高血压患者并发疾病有预测判断价值。

Objective To investigate the telationship of hyperuricemia to senile hypertension and some complications,as well as the clinical value of detecting the content of serum uric acid.Methods The content of cubital veins serum uric acid were determined by uricase in 90 senile hypertension (test group,58 without cardiovascular,cerebral or renal compilcation,32 with complication and 50 heathy old people control group).Results ①The average content of serum urate in control group was lower significantly than that of patients in test group(P<0.01) and there existed significant difference between the patients with or without complacation.②The positive rate to be 41.1%(37of90)in the test group,65.6%(21of32) inpatients with complication and 27.6%(16of58)inpatients without complication,there existed significant difference between the patients with or without complication(χ~2=12.325,(P<0.01).The positive prediction rate was 56.8%(21of37)and the negative prediction rate was 72.4%(42of58).The sensitivity,specificity and accuray of the test to be 65.8%(21of32),72.4%(42of58)and 70%(63of90)respectively.③According to the analysis of ROC curve,the best cut off point was 390.0 μmol/L.The results were as follows:the sensitivity was 78.1%(25of32),the specificity was 67.2%(39of58),the positive prediction rate was 56.8%(25of44),the negative prediction rate was 67.2%(39of58)and the accuracy was 71.1%(64of90).Conclusion There was correlated relationship between the senile hypertension and the serum uric acid,the measurement of the serum uric acid play a reference rate in diagnosing senile hypertension and can be use as an assitant implement to monitor the formation of complication.