中、高度心血管病危险的高血压病患者血清尿酸与血脂的关系

The Correlation between Serum Uric Acid and Blood Lipid among Hypertensive Patients with Moderate and High Risk of Cardiovascular Disease

[目的]研究处于心血管病事件中度和高度危险层(简称"中危层"和"高危层")的原发性高血压患者中血清尿酸(UA)与血脂的关系。[方法]资料来自上海市区4个社区现场调查,共招募1 442名符合危险分层中的中危层和高危层高血压病患者(排除糖尿病和靶器官损害的患者),其中男性占36.27%,女性占63.73%。中危层患者占82.39%,高危层患者占17.61%。用自动生化分析仪测定血清UA、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-c)和低密度脂蛋白胆固醇(LDL-c)。[结果]调查对象高UA血症的患病率为20.2%,中危层的患病率(19.0%)低于高危层者(25.6%),χ2=5.602,P=0.018。女性高危层高血压病患者的血清UA水平(307μmol/L)明显高于中危层者(279μmol/L),Z=-2.935,P<0.01。随着UA水平的递增,所有患者的血清TG平均浓度也随之升高,HDL-c平均浓度则随之降低;男性高危层的UA水平(355μmol/L)与中危层(351μmol/L)差异无统计学意义,Z=-0.335,P>0.05。Spearman秩相关分析发现,血清UA水平与舒张压(DBP)、TG、TC、HDL-c有较好的相关性;经偏相关分析只有TG与血清UA的相关性有统计学意义(r=0.203,P<0.001)。[结论]血清UA在高血压患者中与血脂有平行升高的趋势,只有TG与血清UA水平独立相关,提示血清UA升高可能是预示高血压进展的指标之一。

[ Objective ] To investigate the correlation between serum uric acid（ UA ） and lipidemia profile in essential hypertensive adults with moderate- and high-risk of cardiovascular diseases. [ Methods ] A total of 1442 patients（ male 36.27%, female 63.73% ）without diabetes and target organ damage from 4 communities in Shanghai were selected by risk category. Of them, the proportion of moderate- and high-risk was 82.39% and 17.61% respectively. The serum levels of UA, triglyceride（ TG ）, total cholesterol（ TC ）, high density lipoprotein cholesterol （ HDL-c ）, and low density lipoprotein cholesterol （ LDL-c ）were measured by automatic biochemical analyzer. [ Results ] The prevalence of hyperuricemia was 20.2% in hypertension patients（ moderate- risk 19.0%, high-risk 25.6%, Х^2=5.602,P=0.018 ）. In female patients, serum uric acid level in high-risk was higher than moderate- risk （ 307μmol/L vs. 279 μmol/L, Z=-2.935, P 〈 0.01 ）. The average blood levels of TG was raised, and HDL-c was lowered as increasing of serum UA level. The difference between high- and moderate-risk was not significant （ 355 μmol/L vs 351 μmol/L, Z=-0.335, P 〉 0.05 ）in male. Bivariate Spearman＇ rank correlate analysis showed significant correlation of serum UA with disystolic blood pressure, TG, TC, and HDL-c. Multivariate Partial correlation analysis showed that only correlation with significance was found between serum UA and TG levels（ r=-0.203, P 〈 0.01 ）. [ Conclusion ] Serum UA in hypertension patients shows trend of parallel increament with lipidemia profile. The only independent correlation is found between serum UA and TG. The results suggest that increament of serum UA in hypertensive adults may be one of the predictors of hypertension progression.