血透患者血尿酸水平与血管钙化相关性及非布司他干预作用

Correlation between Blood Uric Acid Level and Vascular Calcification in Hemodialysis Patients and the Intervention Effect of Febuxostat

目的:探析维持性血透患者血尿酸水平与血管钙化相关性以及非布司他干预作用。方法:回顾性分析2016年10月-2020年9月在某院进行维持性血液透析的患者172例,根据条件分为A组、B组和C组。A组血透开始时血尿酸正常,共52例;B组血透开始时即为高血尿酸症,且在1年内未采用非布司他干预者,共56例;C组血透开始时即为高血尿酸症,且在1年内采用非布司他干预者,共64例。比较三组血透开始1年后血管钙化发生情况。结果:B组血管钙化发生率为67.9%,高于A组的42.3%,也高于C组的43.8%,差异均具有统计学意义(P<0.05)。B组患者维持性血液透析1年后冠状动脉钙化评分高于透析前冠状动脉钙化评分,差异具有统计学意义(P<0.05);C组患者维持性血液透析1年后冠状动脉钙化评分低于B组维持性血液透析1年后冠状动脉钙化评分,差异具有统计学意义(P<0.05)。结论:高尿酸血症加剧了维持性血液透析患者血管钙化的发生,采用非布司他降尿酸干预,可以减少血管钙化的发生。

Objective:To explore the correlation between blood uric acid level and vascular calcification in patients with maintenance hemodialysis and the intervention effect of febuxostat.Methods:172 patients undergoing maintenance hemodialysis in a hospital from October 2016 to September 2020 were retrospectively analyzed and divided into group A,group B and group C according to their conditions.52 cases in group A had normal blood uric acid at the beginning of hemodialysis;56 cases in group B had hyperuricemia at the beginning of hemodialysis,and no febuxostat intervention was used within one year;64 cases in group C had hyperuricemia at the beginning of hemodialysis,and they were treated with febuxostat within one year.The incidence of vascular calcification in the three groups one year after the start of hemodialysis were compared.Results:The incidence of vascular calcification ingroup B was 67.9%,which was higher than 42.3% in group A and 43.8% in group C,and the differences were statistically significant(P<0.05).The coronary artery calcification score of patients in group B after one year of maintenance hemodialysis was higher than that before dialysis,the difference was statistically significant(P<0.05).The coronary artery calcification score of patients in group C after one year of maintenance hemodialysis was lower than that in group B,and the difference was statistically significant(P<0.05).Conclusion:Hyperuricemia exacerbates the occurrence of vascular calcification in maintenance hemodialysis patients.The use of febuxostat to lower uric acid intervention can reduce the occurrence of vascular calcification.