血尿酸水平与高血压左心室肥厚的关系

Relationship between serum uric acid and hypertensive left ventricular hypertrophy

目的观察血尿酸水平与高血压左心室肥厚(LVH)之间的关系。方法选取2006-01-2011-12于福建医科大学附属第一医院就诊的高血压患者804例(包括未经降压治疗和已接受降压治疗的患者),其中男性392例,女性412例。根据左心室质量指数(LVMI)≥125(男)、≥120g/m2(女)分为高血压合并LVH组(LVH组,n=181)与高血压无LVH组(non-LVH组,n=623),并按年龄和血压控制情况对高血压患者进行分层。采用超声心动图测定计算LVMI,氧化酶法测定空腹尿酸。用Pearson相关分析和多元线性回归分析血尿酸与高血压LVH的相关性。结果 Pearson相关分析结果表明,入选的高血压患者年龄、脉压、血尿酸水平、低密度脂蛋白胆固醇(LDL-C)与LVMI呈正相关(分别r=0.143、0.167、0.187、0.190,均P<0.05)。中青年组(20~<65岁)或老年组(≥65岁)当血压控制欠佳时,脉压和血尿酸水平与LVMI呈正相关(中青年组分别r=0.220、0.239;老年组分别r=0.224、0.233;均P<0.05);当血压控制达标时,只有血尿酸水平与高血压LVMI呈正相关(中青年组r=0.244;老年组r=0.171,均P<0.05)。多元线性回归分析结果表明,尿酸、脉压、年龄和LDL-C为LVH的共同影响因素(均P<0.05),当血压控制欠佳时,尿酸和脉压为LVH的影响因素(均P<0.05)。结论血尿酸水平与高血压LVH相关,这种关系部分独立于血压之外。

Objective To investigate the relationship between serum uric acid and hypertensive left ventricular hypertrophy （LVH）. Methods From January 2006 to December 2011, 804 hypertensives with or without anti-hy pertensive treatment including 392 males and 412 females from the first affiliated hospital of Fujian medical university were enrolled. Based on the diagnostic criteria of LVH [left ventricular mass index （LVMI） ≥125 （male） or ≥120 g/m2 （female）], the patients were divided into two groups： hypertension with LVH group （LVH group, n=181） and hypertension without LVH group （non-LVH group, n=6231. Patients were also stratified according to their blood pressure control status and ages. LVMI was determined by echocardiography. Serum uric acid was measured by the oxidase method. The association between serum uric acid and hypertensive LVH was analyzed by Pearson correlation analysis and multiple linear regression analysis. Results Pearson correlation analysis showed that the age, pulse pressure, serum uric acid level, and low density lipoprotein cholesterol （LDL-C） were positively correlated with the LVMI （r= 0. 143, 0. 167, 0. 187, 0. 190, respectively; all P〈0.05）. In young/middle-aged （20-〈65 years old） and elderly patients （≥65 years old）, for those without well blood pressure control, pulse pressure and serum uric acid were positively correlated with LVMI （young/middle-aged： r= 0. 220, 0. 239; and elderly： r=0. 224, 0. 233, all P^0.05） and for those with well blood pressure control, only the serum uric acid was positively correlated with LVMI （young/middle-aged： r=0. 244, elderly： r=0. 171, all P〈0.05）. Multiple linear regression analysis showed that the age, pulse pressure, serum uric acid level and LDL-C of the patients were influ encing factors for LVH （all P〈0.05）, only pulse pressure and serum uric acid level were influencing factors for LVH in patients without well blood pressure control （all P〈0.05）. Conclusion Serum uric acid is correlated with LVH independent of blood pressure.