原发性高血压患者颈动脉斑块及动脉僵硬度与血清尿酸水平的关系

Correlation of serum uric acid level with carotid plaques and arterial stiffness in patients with essential hypertension

目的:研究原发性高血压(essential hypertension,EH)患者颈动脉斑块性质及动脉僵硬度与血清尿酸(uric acid,UA)水平的关系。方法:选择EH患者92例,健康对照组30例;对所有研究对象行相关血液生化检查,检测颈总动脉内中膜厚度(IMT)、颈动脉斑块和颈股动脉脉搏波传导速度(CFPWV)。结果:EH组的血清UA明显高于对照组[(361.51±83.81)μmol/L vs(317.03±62.22)μmol/L,P<0.05];EH组IMT及异常检出率较对照组明显升高[(0.69±0.14)mm vs(0.60±0.12)mm,42.39%vs 10.00%,P<0.05];45例EH患者检出颈动脉斑块,随着颈动脉斑块严重程度增高,血清UA水平依次增高[(285.25±78.41)μmol/L、(341.19±63.99)μmol/L和(401.33±88.49)μmol/L,P<0.05];软斑块组(n=11)的血清UA水平较硬斑块组(n=34)显著增高[(389.00±69.45)μmol/L vs(323.03±72.71)μmol/L,P<0.05]。多元线性逐步回归分析显示CFPWV与年龄(r=0.414)、收缩压(r=0.224)、脉压(r=0.270)和血清UA(r=0.219)呈显著正相关(P<0.05)。结论:血清UA水平增高是EH发病的危险因素之一,血清UA水平可反映颈动脉斑块的严重程度及稳定性,EH患者随着血清UA水平增高大动脉弹性减退。

AIM：To study the correlation of serum uric acid （ UA） level with carotid plaques and arterial stiffness in the patients with essential hypertension （ EH） , and to explore the predictive value of serum UA for evaluating EH preclinically .METHODS：A total of 92 patients with EH and 30 healthy individuals were enrolled .The value of UA and other indicators were detected .B-mode ultrasound examination was performed to measure the common carotid artery intima -media thickness （ IMT） and the sites of plaque in the internal carotidartery, external carotid artery and carotid bifurcations.Carotid-femoral arterial pulse wave velocity （ CFPWV） was assessed by Complior atherosclerosis measurement instrument.RESULTS：The serum level of UA in the patients with EH was higher than that in control group [（361.51 ± 83.81） μmol/L vs （317.03 ±62.22） μmol/L, P〈0.05].The mean value and abnormal rate of IMT between hyperten-sion group and control group were significant difference [（0.69 ±0.14） mm vs （0.60 ±0.12） mm, 42.39%vs 10.00%, P〈0.05].In 92 EH patients, 45 cases had carotid plaques .These 45 cases were divided into 3 groups according to the plaque severity, among which the serum UA level had statistically significant differences [（285.25 ±78.41） μmol/L, （341.19 ±63.99） μmol/L and （401.33 ±88.49） μmol/L, P〈0.05].Compared with rigid plaque group （ n=34）, the serum UA level in soft plaque group （n=11） was significantly higher [（389.00 ±69.45） μmol/L vs （323.03 ± 72.71） μmol/L, P〈0.05].A stepwise multiple linear regression analysis demonstrated that age （ r=0.414）, systolic blood pressure （r=0.224）, pulse pressure （r=0.270） and uric acid （r=0.219） were predisposed factors for higher CFP-WV （P〈0.05）.CONCLUSION：UA is one of the risk factors causing hypertension .Serum UA level may reflect the sever-ity and stability of carotid plaques .The increased arterial stiffness is closely related to the increased serum UA level in EH .