疗养院老年人群高尿酸血症发病率及其影响因素分析

The incidence and influential factors of hyperuricemia in older adult patients living in sanatorium

目的分析疗养院老年人群高尿酸血症发病率及其影响因素,以提高高尿酸血症的防治及管理水平。方法选取2017年6月至2019年12月在杭州市五云山疗养院治疗休养的老年人800例,按照高尿酸血症诊断标准统计高尿酸血症发病率,根据是否存在高尿酸血症分为对照组、高尿酸血症组,比较两组一般资料、健康状况、体格检查及实验室检查指标,采用logistic回归分析发生高尿酸血症的影响因素。结果疗养院老年人群高尿酸血症发病率为18.00%(144/800);其中男性发病率为22.17%(104/469),明显高于女性的12.08%(40/331),差异有统计学意义(χ^(2)=13.38,P<0.001)。60~69岁男性高尿酸血症发病率为18.50%(59/319),明显高于女性的5.48%(12/219),差异有统计学意义(χ^(2)=19.20,P<0.001);随着年龄增长,高尿酸血症总体发病率、男性及女性高尿酸血症发病率也随之增高,差异有统计学意义(Z=30.47、11.92、24.81,均P<0.001)。高尿酸血症组与对照组在年龄、性别、饮酒、尿蛋白阳性、运动情况、高三酰甘油(TG)血症、高低密度脂蛋白胆固醇血症及肾功能不全方面比较,差异均有统计学意义(χ^(2)/t=2.36、19.41、41.18、10.11、50.42、8.24、6.43、8.59,均P<0.05);年龄、饮酒、高TG血症及肾功能不全是影响疗养院老年人群高尿酸血症发病的独立危险因素(OR=2.07、2.54、2.31、2.76,95%CI=1.218~3.541、1.740~3.729、1.538~3.468、1.920~3.974),运动是高尿酸血症发病的保护性因素(OR=0.49,95%CI=0.356~0.694)。结论疗养院老年人群中高尿酸血症的发病率偏高,应加强高危人群的防治工作,以降低高尿酸血症发病率。

Objective To investigate the incidence and influential factors of hyperuricemia in older adult patients who live in the sanatorium and to improve the prevention and treatment of hyperuricemia people.Methods A total of 800 older adult patients living in Wuyunshan Sanatorium between June 2017 and December 2019 were recruited for this study.The prevalence of hyperuricemia was determined as per the diagnostic criteria of hyperuricemia.These patients were divided into control and hyperuricemia groups according to whether they had hyperuricemia.General data,health status,physical examination,and laboratory indices were compared between the two groups.The influential factors of hyperuricemia were analyzed using the logistic regression analysis method.Results The incidence of hyperuricemia in older adult patients living in the sanatorium was 18%(144/800).There was significant difference in the prevalence of hyperuricemia between male and female older adults[22.17%(104/469)vs.(12.08%)(40/331),χ^(2)=13.38,P<0.001].The incidence of hyperuricemia was significantly higher in male older adults aged 60-90 years than in female older adults at the same age brackets[18.50%(59/319)vs.5.48%(12/219),χ^(2)=19.20,P<0.001].The overall prevalence of hyperuricemia and the prevalences of hyperuricemia in male and female older adults significantly increased with aging(Z=30.47,11.92,24.81,P<0.001).There were significant differences in age,sex,alcohol consumption,urinary protein-positive,exercise,the prevalences of hypertriglyceridemia,hypercholesterolemia,and renal insufficiency between the control and hyperuricemia groups(χ^(2)/t=2.36,19.41,41.18,10.11,50.42,8.24,6.43,8.59,all P<0.05).Age,alcohol consumption,hypercholesterolemia and renal insufficiency were independent risk factors of hyperuricemia in older adults living in sanatorium(OR=2.07,2.54,2.31,2.76,95%CI=1.218-3.541,1.740-3.729,1.538-3.468,1.920-3.974).Exercise was a protective factor of hyperuricemia(OR=0.49,95%CI=0.356-0.694).Conclusion Older adults living in sanatorium have a high incidence of hyperuricemia.Prevention and treatment of hyperuricemia should be strengthened in older adults who have a high risk for hyperuricemia to reduce the incidence of hyperuricemia.