原发性高血压患者血尿酸浓度与早期肾功能损伤的关系

Correlation between serum concentration of uric acid and early renal damage in patients with essential hypertension

目的探讨血尿酸浓度检测在原发性高血压(高血压)患者早期肾功能损伤诊断中的临床价值。方法选择2015年1月至2016年1月深圳市第四人民医院290例高血压患者(高血压组)和120名健康体检者(对照组),将高血压患者分为肾功能损伤亚组(86例)和无肾功能损伤亚组(204例),比较各组性别构成比、年龄、体质量指数(body mass index,BMI)、脉压差、尿微量白蛋白(urinary microalbuminuria,MAU)、血肌酐(se-rum creatinine,Scr)、尿素氮(urea nitrogen,BUN)、尿酸(uric acid,UA)、空腹血糖(fasting plasma glucose,FPG)、肾小球滤过率(glomerular filtration rate,GFR)和血脂各项指标[包括总胆固醇(total cholesterol,TC)、三酰甘油(triacylglycerol,TG)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)和低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)]。分析GFR与其他各指标的相关性,分析高血压患者早期肾功能损害的独立危险因素。结果高血压组BMI、GFR及血SCr、UA、MAU、TG浓度均高于对照组,差异有统计学意义(P<0.01);HDL-C浓度低于对照组,差异有统计学意义(P<0.01)。高血压患者中肾功能损伤亚组BMI、SCr、UA、MAU、GFR及脉压差均高于无肾功能损伤亚组,差异有统计学意义(P<0.01)。Pearson相关分析显示BMI、SCr、UA、MAU及脉压差与GFR呈负相关(r=-0.230、-0.436、-0.267、-0.351、-0.324,P均<0.05);血UA浓度是高血压患者早期肾功能损害的独立危险因素。结论血UA浓度在一定程度上可反映肾功能损害的程度,可作为高血压患者早期肾功能损伤诊断的有效指标。

Objectives To investigate the value of serum concentration of uric acid(UA)detection in diagnosis of ear?ly hypertensive renal damage in patients with essential hypertension.Methods Totally290patients with essential hy?pertension(hypertension group)and120healthy controls(control group)were selected from January2015to January2016in Shenzhen Fourth People′s Hospital.Patients with hypertension were divided into renal injury subgroup(86cas?es)and normal renal function subgroup(204cases).And the gender composition ratio,age,body mass index(BMI),pulse pressure difference,urinary microalbuminuria(MAU),serum creatinine(Scr),urea nitrogen(BUN),UA,fasting plasma glucose(FPG),glomerular filtration rate(GFR)and blood lipids index including total cholesterol(TC),triacylglycerol(TG),high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein cholesterol(LDL-C)were compared.Correlations between GFR and other various indices were analyzed.Independent risk factorsfor hypertension patients with early renal damage were analyzed.Results BMI,GFR and serum concentrations of Cr,UA,MAU,TG of hypertension group were significantly higher than those of control group(P<0.01);serum concentra?tion of HDL-C was significantly lower than that of control group(P<0.01).BMI,SCr,UA,MAU,GFR and pulsepressurein difference of renal injury subgroup were significantly higher than those of normal renal injury subgroup(P<0.01).Pearson correlation analysis showed that BMI,SCr,UA,MAU and pulse pressure difference negatively correlat?ed with GFR(r=-0.230,-0.436,-0.267,-0.351,-0.324,P<0.05).Serum concentration of UA was an independent risk factor for hypertension patients with early renal damage.Conclusions Serum concentration of UA can reflect thedegree of renal impairment,and it can be used as an effective indicator in diagnosis of early renal damage in patientswith essential hypertension.