血液透析患者血清尿酸与C反应蛋白水平的相关研究

Serum Uric Acid Correlates with C-Reactive Protein Level in Hemodialysis Patients

目的:验证血清尿酸(SUA)与C反应蛋白(CRP)的关系及两者在血液透析患者心血管事件发生中是否存在协同作用。方法:本研究入组的67例患者均为在我院血净中心进行常规血液透析(透析龄≥3个月)的患者。所有患者均无明显感染和传染性疾病病史。检测患者的基线SUA、CRP、KT/V及其他临床指标。并对患者进行了6个月的随访,以观察高尿酸血症合并CRP升高对血液透析患者心血管并发症的影响。结果:67例患者均完成了6个月的随访,未出现死亡病例。入组时平均SUA水平为(459.6±128.9)μmol/L,其中高尿酸血症患者38例(56.7%);CRP升高者35例(52.2%)。高尿酸血症伴CRP升高者24例(35.8%)。多元回归分析显示,在进行年龄、性别、体重、Kt/V、三酰甘油、吸烟史、糖尿病病史、高血压等校正后,血清尿酸仍与CRP-log明显相关关系(OR:2.24,Z=2.24,P=0.001)。随访6个月,67例血液透析患者中共有26例(38.8%)患者发生心血管事件,其中高尿酸血症伴CRP升高组心血管事件发生率70.8%(17/24);单纯高尿酸血症组27.3%(3/11);单纯CRP升高组28.6%(4/14)血清尿酸及CRP水平均正常组11.1%(2/18)。结论:血液透析患者的血清尿酸水平与C反应蛋白水平可能相关。高尿酸血症与CRP共同作用可增加血液透析患者心血管事件的发生率。

Objective：To investigate the relationship serum uric acid （SUA） and C- reactive protein （CRP） and their cooperation in cardiovascular risk. Methods： This study included 67 maintenance hemodialysis patients（time for hemodialysis≥3 month） who were followed-up for more than 6 months in our blood purification center. The baseline included SUA,CRP,KT/V and other clinical index. Results：All of 67 patients complete 6 - month follow - up, including hyperuricenfia 38 （56.7%）, elevated CRP 35 （52.2%） and hyperuricemia wth elevated CRP 24 （35.83%）. Multiple regression analysis showed that the serum uric acid positive correlated to CRP - log even corrected by age, gender, weight, KT/V,serum triglyceride, history of smoke, diabetes and hypertension. Cardiovascular events occurred in 26 patients （26/67, 38.8% ）, 17/24（70.8% ） in hyperuricemia and elevated CRP group, 3/11（27.3 % ） in single hyperuricemia group, 4/14 （28.6 % ） in single elevated CRP group and 2/18 （11.1% ）. Conclusion： The serum uric acid level in hemodialysis could be positive correlated to CRP level. Their cooperation could increase the incidence of cardiovascular disease in hemodialysis patients.