高尿酸血症发生痛风的相关危险因素研究

Study on the risk factors of gout in adults with hyperuricemia

目的探讨影响成年人群高尿酸血症(HUA)者发生痛风的危险因素,为痛风源头预防提供科学依据。方法采用1∶1配对病例对照研究的方法,从2015—2016年广西痛风流行病学调查研究病例中,选出痛风患者129人作为病例组,以同性别、同民族、年龄相差±3岁、同乡镇的单纯高尿酸血症者129人作为对照组;调查收集两组人群一般情况、行为习惯、饮食情况、疾病史、家族史,以及体检、实验室检测等数据,用多因素条件logistic回归分析,探讨痛风发病的危险因素。结果多因素条件logistic回归分析发现,痛风家族史、动物内脏摄入量≥25 g/d、超敏C反应蛋白(hs-CRP)≥2.5 mg/L、同型半胱氨酸(Hcy)≥15μmol/L均可显著增加高尿酸血症者发生痛风的风险,其危险度[OR(95%CI)分别为2.473(1.065-5.744)、2.595(1.025-6.572)、2.535(1.354-4.749)和3.861(1.887-7.901)]。结论痛风家族史、动物内脏摄入量大、hs-CRP升高、Hcy升高是高尿酸血症者发生痛风的危险因素。为预防和减少痛风的发作,建议高尿酸血症者定期检查血液生化指标,减少动物内脏摄入量。

Objective To investigate the risk factors of gout progress in adults with hyperuricemia and provide a scientific evidence for early prevention of gout.Methods A 1：1 matched case-control study was carried out. Data were from the investigation of gout in 2015-2016 in Guangxi. The case group had 129 gout patients and 129 cases of only hyperuricemia as control group, whose sex, ethnic, age（ plus or minus 3 years） and residental town was matched with those of the case group. The data including the demographic characters, behavior habits, diet, personal disease history and family history of gout attacks,results of physical examinations and laboratory tests of the blood biochemical indexs were collected. Multivariate conditional logistic regression analyses was applied to explore the risk factors of gout attack. Results The results of multivariate logstic regression analysis showed that family history of gout attacks,animal offal intake ≥25 g/d, hs-CRP≥2.5 mg/L and hyperhomocysteinemia（≥15 μmol/L） increased the risk of gout in patients with hyperuricemia; the OR（95%CI） valuses were 2.473（1.065-5.744）, 2.595（ 1.025-6.572）,2.535（ 1.354-4.749） and 3.861（ 1.887-7.901）, respectively. Conclusions Family history of gout attacks, prefering to take animal offal, elevated hs-CRP and hyperhomocysteinemia are risk factors of gout attacks in patients with hyperuricemia. For preventing and reducing the risks of gout attacks for patients with hyperuricemia one should decrease the intake of animal offal and regually monitor the blood biochemical indexs.