肝移植后高尿酸血症的发生率和相关危险因素分析：单中心回顾性研究

The incidence and risk factors of hyperuricemia after liver transplantation： a single-center retrospective study Rao Weiping

目的分析肝移植术后高尿酸血症的发病率和相关危险因素。方法选取2009年至2012年在武警总医院接受肝移植手术、术前尿酸正常、随访时间超过1年的患者，共286例，回顾分析患者临床资料，包括肾功能、血糖、血脂，统计肝移植后高尿酸血症的发生率，分析可能的危险因素。结果53．5％（153／286）患者出现移植后高尿酸血症；二分类logistic回归分析表明，年龄是总体肝移植后患者发生高尿酸血症的预测因子（P=0．038），较高的BMI是女性患者发生高尿酸血症的预测因子（P=0．027）。高尿酸血症组出现血脂升高比例为60．1％（92／153），高于正常尿酸组的39．1％（52／133）（P〈0．05）。结论肝移植术后高尿酸血症发生率较高，高龄是患者发生移植后高尿酸血症的危险因素，具有较高BMI的女性移植受者发生高尿酸血症的机会更大。术后高尿酸血症患者常伴发血清肌酐、血脂升高，应加强对患者随访，早发现早治疗。

Objective To analyze the incidence and related risk factors of hyperuricemia after liver transplantation. Methods A total of 286 cases undergoing liver transplantation from 2009 to 2012 in the Armed Police General Hospital, who had normal uric acid before transplantation and had been followed up for more than 1 year, were enrolled in this study. The clinical data, including liver and kidney function, blood glucose, and lipids were collected. The potential risk factors of hyperuricemia were analyzed. Results 53.5% cases （ 153/ 286） had hyperuricemia after transplantation. Hyperuricemic patients were predominately older（ P = 0. 038 ）. They also had a higher prevalence of increasing creatinine （ P = 0. 000）, and hyperlipidemia （ P = 0. 000）. Among female cases, hyperuricemic patients had a higher average BMI （P = 0. 027 ）. Hyperurieemia group had an elevat- ed ratio of blood lipids 60. 1% （ 92/153 ）, higher than normal uric acid group （ 39. 1%, 52/133 ） （ P 〈 0.05 ）. Conclusions Liver transplantation recipients have a higher incidence of hyperuricemia, particularly in elderly and overweight female patients. Our findings suggest that postoperative hyperuricemia may be associated with high serum creatinine, elevated blood lipids. We should strengthen follow-up, take early detection and early treatment.