慢性肾脏病3期患者血尿酸及同型半胱氨酸水平与动脉硬化的相关性

Correlations between serum uric acid and homocysteine levels and arteriosclerosis in patients with chronic kidney disease stage 3

目的:探讨慢性肾脏病(CKD)3期患者血尿酸(SUA)及同型半胱氨酸(Hcy)水平与动脉硬化(AS)的相关性。方法:检测140例CKD 3期患者的血浆SUA及Hcy水平,测量患者的颈动脉内膜中层厚度(IMT)、颈动脉斑块、肱踝脉搏波传导速度(ba-PWV),并根据IMT和颈动脉斑块将患者分为AS组和对照组。分析SUA、Hcy与AS指标的相关性,并采用Logistic回归分析SUA、Hcy是否是CKD 3期患者合并AS的影响因素;采用ROC曲线分析SUA、Hcy单独及联合诊断CKD 3期患者合并AS的性能。结果:AS组SUA、Hcy水平均显著高于对照组(P<0.05);SUA及Hcy与IMT、ba-PWV均呈显著正相关性;高SUA、Hcy是CKD 3期患者合并AS的独立危险因素;SUA联合Hcy诊断CKD 3期合并AS的性能优于单一指标。结论:CKD 3期患者的SUA、Hcy水平与AS指标密切相关,二者联合可用于CKD 3期患者出现血管硬化的预测诊断。

Objective: To investigate the correlations between the levels of serum uric acid(SUA) and homocysteine(Hcy) and arteriosclerosis(AS) in patients with chronic kidney disease stage 3(CKD3). Method: The plasma SUA and Hcy levels of 140 CKD 3 patients were test. The carotid intima-media thickness(IMT), carotid plaque and brachio ankle pulse wave velocity(ba-PWV) were measured and the patients were divided into the AS group(n=78) and control group(n=62) according to the IMT and carotid plaque. The correlations between SUA, Hcy and AS indexes were analyzed and Logistic regression was used to analyze whether they were the influencing factors of CKD3 patients complicated with AS. The performance of SUA and Hcy in the diagnosis of AS alone and in combination were analyzed by ROC curve. Result: The levels of SUA and Hcy in AS group were significantly higher than those in control group(P<0.05). The level of SUA and Hcy were significantly positively correlated to IMT and ba-PWV. High SUA and Hcy were independent risk factors of AS. SUA combined with Hcy was superior to single index in the diagnosis of AS of CKD3 patients. Conclusion: SUA and Hcy in CKD 3 patients were closely related to AS indexes and the combination of the two could be used for diagnosis of AS in CKD 3 patients.