住院高血压患者高尿酸水平对靶器官的影响研究

Influence of higher level of blood uric acid on target organs in inpatients with hypertension

目的探讨住院高血压患者尿酸水平对靶器官的影响。方法利用计算机FusionInsight Hadoop数据处理平台,入选2012年12月至2013年12月于郑州大学第一附属医院住院的高血压患者53007例。根据血尿酸水平分为高尿酸组(A组,n=7808)、正常尿酸组(B组,n=45199);男性高尿酸组(C组,n=4150)、男性正常尿酸组(D组,n=23987)、女性高尿酸组(E组,n=3658)、女性正常尿酸组(F组,n=21212)。收集患者病史资料及检查结果,分析高血压患者合并高尿酸等危险因素与靶器官的关系。结果对收缩压、舒张压、脉压、总胆固醇、三酰甘油、低密度脂蛋白胆固醇(LDL-C)、血肌酐、同型半胱氨酸值进行比较,发现A组高于B组;C组高于D组;E组高于F组,差异有统计学意义(P<0.05)。A组、C组、E组的冠状动脉粥样硬化性心脏病(冠心病)、心房颤动(房颤)、左室肥厚发生率高(P<0.05);而B组、D组、F组缺血性卒中、出血性卒中发生率高(P<0.05)。高尿酸组合并1个及以上靶器官受损比率明显高于正常尿酸组(P<0.05)。多元Logistic回归分析发现,高尿酸水平增加冠心病、肾损伤、左室肥厚的风险,降低脑卒中的风险(P<0.05)。结论在住院高血压患者中,高尿酸能增加高血压合并冠心病、肾损伤、左室肥厚的风险,但能降低脑卒中的风险。

Objective To discuss the influence of level of blood uric acid(BUA)on target organs in inpatients with hypertension.Methods The patients with hypertension(n=53007)were chosen by applying computer FusionInsight Hadoop data processing platform the First Affiliated Hospital of Zhengzhou University from Dec.2012 to Dec.2013.All patients were divided,according to BUA level,into high BUA group(group A,n=7808),normal BUA group(group B,n=45199),male high BUA group(group C,n=4150),male normal BUA group(group D,n=23987),female high BUA group(group E,n=3658)and female normal BUA group(group F,n=21212).The medical history materials and examination results were collected in all groups,and relationship between risk of high BUA and target organs was analysis in hypertensive patients.Results The levels of blood systolic pressure,blood diastolic pressure,pulse pressure,total cholesterol,triglyceride,low-density lipoprotein cholesterol(LDL-C),serum creatinine and homocysteine were higher in group A than those in group B,higher in group C than those in group D,and higher in group E than those in group F(P<0.05).The incidence rates of coronary heart disease(CHD),left ventricular hypertrophy(LVH)and atrial fibrillation were higher in group A,group C and group E(P<0.05),and incidence rates of ischemia stroke and hemorrhagic stroke were higher in group B,group D and group F(P<0.05).The percentage of patients with injury of 1 or more target organs was significantly higher in high BUA groups than that in normal BUA groups(P<0.05).The results of multi-factor Logistic regression analysis showed that high BUA level increased the risks of CHD,kidney damage and LVH,and decreased risk of stroke(P<0.05).Conclusion High BUA level can increase the risks of CHD,kidney damage and LVH,and decrease risk of stroke in inpatients with hypertension.