高血压患者血尿酸水平与靶器官损害关系探讨

The Correlation Analysis between the serum uric acid and the Target Organs Damage in Essential Hypertension

目的探讨高血压患者血尿酸水平与靶器官损害之间的关系。方法纳入我院高血压住院患者254例,测定患者血尿酸(UA)水平并将患者分为A组(高尿酸血症组,共86例)和B组(血尿酸正常组,共168例)。以左心室质量指数(LVMI)、颈动脉内膜中层厚度(IMT)及尿微量白蛋白/肌酐比值(尿ACR)、内生肌酐清除率(Ccr)作为高血压靶器官损害的观察指标。结果 1、患者一般情况比较:A、B两组患者在性别构成上有统计学差异,男性高血压患者中高尿酸血症比例高于女性(35.1%vs.32.8%,P=0.019);A、B两组患者的体重指数(BMI)有统计学差异,A组明显高于B组(27.92±4.03,26.14±3.83,P=0.001)。A、B两组之间年龄、收缩压、脉压、空腹血糖无统计学差异。2、A、B两组之间LVMI有统计学差异,且A组高于B组(106.13±22.65,99.99±24.94,P=0.048);A、B两组之间IMT无差异(P=0.867);A、B两组之间尿ACR无统计学差异(P=0.094)。A、B两组之间的Ccr有统计学差异,且A组明显低于B组(75.21±37.40,88.11±32.92,P=0.008)。3、在LVMI的多元回归方程里,年龄(r=0.159,P=0.010)、收缩压(r=0.179,P=0.004)、尿酸(r=0.156,P=0.011)均有意义,且与LVMI呈正相关。在Ccr的多元回归方程里,仅年龄(r=-0.706,P<0.001)、尿酸(r=-0.122,P=0.006)有统计学意义,且与Ccr呈负相关。结论高血压患者血尿酸水平与LVMI呈正相关,且在血压水平较高的老年患者中更为明显;血尿酸水平与内生肌酐清除率呈负相关,尤其在较年老的患者中更为明显;高血压患者颈动脉内膜中层厚度、尿ACR受众多因素的影响,未发现与血尿酸水平有明确的相关性。

Objective To analyze the relationship between the serum uric acid and the target organs damage in essential hypertension. Methods 254 hypertensive patients were selected, who were all measured the the level of serum uric acid （UA） ,and were divided into group A （hyperuricemia, 86 cases ） and group B（none-hyperuricemia ,168 cases）.We selected left ventricular mass index（LVMI）, the carotid intimal medial thickness （IMT） and urinary microalbumin to creatinine ratio（ACR）, endogenous creatinine clearance rate（Ccr） as the target parameters. Results 1. There was significant difference of sex composition between group A and group B, the male hyperuricemia rate was higher than that of the female in the hypertensive patients （35.1% vs. 32.8%, P=0.019）. The BMI （body mass index, BMI） of group A was obviously higher than that of group B （27.92±4.03, 26.14±3.83, P=0.001）, too. There was no significant difference of age, systolic blood pressure ~ pulse pressure, blood lipid and fasting blood-glucose between group A and group B. 2. The difference of LVMI between group A and group B was significant （ 106.13±22.65, 99.99±24.94, P=0.048）.There was no significant difference of IMT and urinary ACR between group A and group B .The analysis of Ccr also showed that the Ccr of group A was significantly lower than that of group B（75.21±37.40, 88.11±32.92, P=0.008）. 3. The age, systolic pressure and serum uric acid were shown statistically significant in the multiple regression equation of LVMI, and they were in positive correlations with LVMI. Only the age and serum uric acid were shown statistically significant in the multiple regression equation of Ccr, and furthermore, they were in negative correlations with Ccr. Conclusion The UA was in positive correlation with LVMI , especially in the older patients with higher blood pressure . The UA was in negative correlation with Ccr, especially in the older patients. We did not find that IMT and urinary ACR related definitely with UA because they were influenced by many other factors in hypertensive patients.