血脂正常原发性高血压患者血尿酸水平与颈动脉粥样硬化的关系

Relationship between blood uric acid level and carotid atherosclerosis in patients with hypertension and normal blood lipids

目的探讨血脂正常原发性高血压患者血尿酸水平与颈动脉粥样硬化(carotid atherosclerosis,CAS)斑块及硬化程度的关系。方法选择血脂正常的原发性高血压患者288例,行颈动脉彩色多普勒超声检查,测量左右颈动脉内膜中层厚度,根据测量结果分为斑块组(104例)和无斑块组(184例),将患者CAS程度分为0～4级,所有患者测血脂、血尿酸水平。结果斑块组血尿酸浓度明显高于无斑块组(481 μmol/L vs 289μmol/L,P<0.05)。斑块组高尿酸血症发生率较无斑块组明显增高(66.2% vs 13.8%,P<0.05)。与CAS 3级患者比较,CAS 0级、1级患者血尿酸水平明显下降;与CAS 4级患者比较,CAS 0级、1级、2级患者血尿酸水平明显下降,差异有统计学意义(P<0.05)。结论血脂正常的原发性高血压患者中,CAS斑块形成可能与血尿酸水平升高有关,CAS程度愈高,其相关性愈大。

Objective To investigate the relationship of blood uric acid（UA） level with the plaque and degree of the carotid atherosclerosis（CAS） in patients with hypertension. Methods 288 patients with primary hypertension received the colour Doppler ultrasonography to measure the intima-media thickness of bilateral carotid arteries. Then the patients were divided into group with CAS plaque（104 cases） and group without CAS plaque（188 cases） according to the result of ul- trasonography. The degree of CAS was divided into 0--4 levels. The levels of serum uric acid and lipids were examined. Results The concentration of plasma UA in the group with C.AS plaque was significantly higher than that in group without CAS plaque （481 μmol/L vs 289 μmol/L, P〈 0.05）. The incidence of hyperuricemia in the group with CAS plaque was also significantly higher than that in group without CAS plaque （66.2% vs 13.8%, P 〈 0.05）. The concentration of plasma UA in patients with degree 3 CAS was higher compared with patients with degree 0--1 CAS, in patients with degree 4 CAS was higher compared with patients with degree 0 -- 2 CAS, the difference was statistically significant （P 〈0. 05）. Conclusions The formation of CAS plaque may be closely associated with the increased level of plasma uric acid in patients with hypertension. The higher the CAS degree, the greater the correlation.