维持性血液透析患者血尿酸与心血管疾病的关系

Association of blood uric acid with cardiovascular disease in maintenance hemodialysis patients

目的分析维持性血液透析患者血尿酸水平与心血管疾病的关系,探讨高尿酸在心血管疾病的发生、发展中的作用。方法选择维持性血液透析患者60例,分为血尿酸升高组(35例)和血尿酸正常组(25例),彩色多普勒超声检测两组患者的左室舒张末期内径(LVDd)、室间隔(IVS)、左室舒张末期厚度(PWTH)、左室后壁(LVPW),收集血清标本,测定GFR、TC、TG、LDL、BUN、Cr、CRP、UA。结果尿酸升高组LVMI、RWT高于尿酸正常组(分别是P=0.022,P=0.030),E/A低于尿酸正常组(P=0.019)。在尿酸升高组中高血压的发生率,UN、Cr、LDL、CRP的水平显著高于尿酸正常组(P<0.05),而残余GFR低于尿酸正常组(P<0.05);多元线性回归分析显示血尿酸与LDL、CRP呈正相关(P<0.05),与GFR呈负相关(P<0.01)。结论维持性血液透析患者高尿酸血症与脂质代谢紊乱、CRP升高、残余肾功能的下降明显相关,增加了维持性血液透析患者CVD的发生风险。

Objective To analyze the association of serum uric acid with cardiovascular disease in maintenance hemodialysis patients and to explore the role of high uric acid in the occurrence and development of cardiovascular disease.Methods The study included 60 MHD patients who were divided into hyperuricemia group of 35 patients and normouricemia group of 25 patients.Cardiac function were determined by color doppler ultrasonic in two groups：LVDd,IVS,PWTH,LVPW.Serum specimens were collected.Serum were sampled for the determination of GFR,TC,TG,LDL,BUN,Cr,CRP,UA.Results The incidence of LVMI,RWT were higher in hyperuricemia group than those in normouricemia group（P=0.022,P=0.030）,but the incidence of E/A was lower than that in normouricemia group（P=0.019）.The incidence of hypertension,the levels of UN,Cr,LDL and CRP in hyperuricemia group were higher than those in normouricemia group（P〈0.05）,but the level of residual kidney filtration rate was lower than that in normouricemia group（P〈0.05）.Multiple linear regression analyses showed that UA was positive related to LDL,CRP,and was negative related to GFR（P〈0.01）.Conclusion Hyperuricemia was positive related to lipid metabolic disorder,high level of CRP and the losing of residual renal function in maintenance hemodialysis patients,which increased the risk of CVD.