肾内科门诊高尿酸血症患者血尿酸达标率的横断面分析

Cross-sectional analysis of the control rate of hyperuricemia among outpatients in nephrology department

目的探讨肾内科门诊高尿酸血症患者的治疗现状、血尿酸达标率及其影响因素。方法本研究为横断面分析,纳入2019年4月至2020年7月复旦大学附属中山医院肾内科门诊就诊的1499例高尿酸血症患者,比较不同临床特征患者的治疗方案及血尿酸控制情况,分析患者血尿酸达标率及其影响因素。结果1499例高尿酸血症患者,平均年龄(55.9±17.7)岁,估算肾小球滤过率(eGFR)小于60 mL/(min·1.73 m^(2))752例(50.2%)。1246例(83.1%)患者使用降尿酸药物治疗,30岁以下患者药物治疗率较低(P<0.01);相较于肾功能减退患者,肾功能正常患者药物治疗率较低(P<0.01)。患者平均血尿酸水平(431.5±118.3)μmol/L,血尿酸达标率46.4%,男性达标率为44.1%、女性为55.3%,差异有统计学意义(P<0.01)。相对于其他年龄组,30岁以下男性患者血尿酸达标率更低(P<0.01)。多因素logistic回归分析提示血尿酸控制与患者年龄、性别有关,男性(P<0.05)及30岁以下(P<0.01)患者血尿酸更不易达标。结论肾内科门诊就诊的高尿酸血症患者血尿酸达标率有待进一步提高,临床需重视年轻、男性患者尿酸水平管理和规范治疗。

Objective To explore the treatment status,control rate and influencing factors in outpatients with hyperuricemia in nephrology department.Methods 1499 outpatients of the Department of Nephrology,Zhongshan Hospital,Fudan University between April 2019 and July 2020 were included in this cross-sectional study.The treatment options and hyperuricemia control status of patients with different clinical characteristics were compared,influencing factors of compliance were analyzed.Results A total of 1499 patients with hyperuricemia were included,with an average age of(55.9±17.7)years old.The estimated glomerular filtration rate(eGFR)was less than 60 mL/(min·1.73 m^(2))in 752 cases(50.2%).1246 patients(83.1%)were treated with uric acid-lowering drugs with a significant lower rate in patients under 30 years old(P<0.01).The treatment rate of patients with normal renal function was significantly lower than that of patients with impaired renal function(P<0.01).The average serum uric acid level was(431.5±118.3)μmol/L.The whole control rate of hyperuricemia was 46.4%with 44.1%in men and 55.3%in women,the difference of which was statistically significant(P<0.01).Male patients under the age of 30 years old had lowest control rate compared with other age group(P<0.01).Multivariate logistic regression analysis indicated that male(P<0.05),age under 30 years old(P<0.01)were related factors to the control of hyperuricemia.Conclusions The control rate of hyperuricemia remains to be further improved in nephrology department,attention should be attached to the treatment and management of hyperuricemia in young male patients.