老年高血压病人颈动脉内膜-中层厚度和血清尿酸的相关性分析

Correlation analysis of serum level of uric acid with intima-media thickness in elderly patients with hypertension

目的:通过分析老年原发性高血压病人血清尿酸(UA)与颈动脉内膜-中层厚度(IMT)的相关性,探讨血清UA在动脉硬化形成中可能发挥的作用。方法:收集年龄>65岁的138例老年高血压病人临床资料,按照超声测定结果分为内膜正常组(G1组)35例、内膜增厚组(G2组)30例、稳定斑块组(G3组)36例及非稳定斑块组(G4组)37例,统计并分析各组间临床资料的差异,并对IMT和血清UA进行相关分析。结果:4组病人在空腹血糖、糖化血红蛋白差异无统计学意义(P>0.05),但是随着IMT厚度的增加,血清UA水平呈增加趋势,收缩压、舒张压、血清总胆固醇、低密度脂蛋白胆固醇、三酰甘油、C反应蛋白水平呈上升趋势,血清高密度脂蛋白胆固醇水平呈下降趋势,差异均有统计学意义(P<0.05~P<0.01)。相关分析结果显示,高血压病人中颈动脉内膜-中层厚度和高密度脂蛋白胆固醇呈负相关(r=-0.315,P<0.05),和低密度脂蛋白胆固醇水平呈正相关(r=0.212,P<0.05),与血清UA水平呈正相关(r=0.412,P<0.05),与血清C反应蛋白呈正相关(r=0.223,P<0.05)。结论:UA在动脉粥样硬化的发生发展中发挥一定的作用,其机制可能是氧化应激所致的慢性炎症。

Objective: To analyze the correlation of serum uric acid( UA) with intima-media thickness( IMT) in elderly patients with hypertension,and explore the possible role of serum UA in atherosclerosis.Methods: One hundred and thirty-eight senile hypertension patients with age greater than 65 years were divided into the normal endometrium group( G1,35 cases),endometrial thickening group ( G2,30 cases),stable plaque group( G3,36 cases) and unstable plaque group( G4,37 cases) according to the results of ultrasound. The clinical data of all cases were analyzed,and the correlation of IMT with UA was analyzed.Results: The differences of the levels of fasting blood glucose and glycosylated hemoglobin among four groups were not statistically significant( P > 0.05).With the increasing of IMT,the serum levels of uric acid,total cholesterol,low-density lipoprotein cholesterol,triglyceride,systolic pressure and diastolic pressure increased,and the serum level of high-density lipoprotein cholesterol decreased,and the differences of those were statistically significant( P < 0.05 to P < 0.01).The results of correlation analysis showed that the IMT in patients with hypertension was negatively correlated with high-density lipoprotein cholesterol( r =- 0.315,P < 0.05),and positively correlated with low-density lipoprotein cholesterol level( r = 0.212,P < 0.05),uric acid level( r = 0.412,P < 0.05),and C reactive protein level( r = 0.223,P < 0.05). Conclusions: Uric acid plays certain role in the occurrence and development of atherosclerosis,and its mechanism may be related to the chronic inflammation caused by oxidative stress.