不同年龄痛风患者临床特征分析

Clinical features analysis of patients of different ages with metabolic arthritis

目的:比较3组不同年龄痛风患者的临床特征,了解其临床特点以便于临床的诊疗及预后的判断。方法:收集2016年6月—2020年6月扬中市人民医院肾内科住院的痛风患者205例,按年龄分为青年组51例(≤44岁)、中年组67例(45~64岁)及老年组87例(≥65岁),分别收集并比较3组患者临床资料和相关生化检测结果。结果:老年组男性痛风患者所占比例(80.46%)低于中年组(97.01%)和青年组(98.04%),老年组女性痛风患者所占比例(19.54%)高于中年组(2.99%)和青年组(1.96%),差异均有统计学意义(P<0.05)。老年组高血压病合并率(85.06%)、慢性肾脏病合并率(35.63%)及脑梗死合并率(13.79%)高于中年组(58.21%、19.40%、2.99%)及青年组(29.41%、7.84%、0),中年组糖尿病合并率(14.93%)高于青年组(3.92%),老年组冠心病合并率(12.64%)高于青年组(1.96%),差异均有统计学意义(P<0.05)。老年组血尿素氮[(7.71±3.20)mmol/L]、血肌酐[(111.14±43.08)umol/L]和胱抑素c[(1.78±0.67)mg/L]水平高于中年组[(5.75±2.33)mmol/L、(91.15±37.40)umol/L、(1.37±0.62)mg/L]及青年组[(4.85±2.42)mmol/L、(80.55±36.16)umol/L、(1.18±0.68)mg/L],总胆固醇[(4.41±1.16)mmol/L]和甘油三酯[(1.35±0.67)mmol/L]水平低于中年组[(4.94±1.06)mmol/L、(2.49±1.92)mmol/L]及青年组[(5.00±1.30)mmol/L、(3.01±2.70)mmol/L](P<0.05),低密度胆固醇[(2.13±0.70)mmol/L]水平低于青年组[(2.66±1.07)mmol/L],差异均有统计学意义(P<0.05)。治疗3个月后,3组患者血尿酸水平均低于治疗前(P<0.05),但3组组间比较差异无统计学意义(P<0.05)。结论:不同年龄的痛风患者临床特点不同,因此临床应区别干预。

Objective:To compare clinical features of three groups of patients of different ages with metabolic arthritis and to investigate the features so as to provide help in clinical diagnosis and prognosis.Methods:205 patients with metabolic arthritis hospitalized in Yangzhong People's Hospital from June 2016 to June 2020 were collected and were divided into a junioRyoung group(51 cases,≤44 ages),a middle aged group(67 cases,45~64 ages)and a senioRgroup(87 cases,≥65 ages).Clinical data and relative biochemical test results were collected and compared between the three groups.Results:Male patients with metabolic arthritis in the senioRgroup accounted foR80.46%,loweRthan those in the middle aged group(97.01%)and the junioRyoung group(98.04%),while female patients in the senioRgroup accounted for19.54%,higheRthan those in the middle aged group(2.99%)and the junioRyoung group(1.96%),the differences being of statistical significance(all P<0.05).Rates foRcomplications of hypertension,chronic kidney disease and cerebral Infarction in the senio Rgroup were respectively 85.06%,35.63%and 13.79%,higheRthan those in the middle aged group(58.21%,19.40%,2.99%)and junioRyoung group(29.41%,7.84%,0%);rate foRcomplication of diabetes in the middle aged group was 14.93%,higheRthan that in the junioRyoung group(3.92%);rate fo Rcomplication of coronary heart disease in the senioRgroup was 12.64%,higheRthan that in the junioRyoung group(1.96%)(all P<0.05).Blood urea nitrogen,serum creatinine and cystatin-C in the senioRgroup were respectively(7.71±3.20)mmol/L,(111.14±43.08)umol/L and(1.78±0.67)mg/L,higheRthan those in the middle aged group[(5.75±2.33)mmol/L,(91.15±37.40)umol/L,(1.37±0.62)mg/L]and those in the junioRyoung group[(4.85±2.42)mmol/L,(80.55±36.16)umol/L,(1.18±0.68)mg/L];Total cholesterol and triglyceride[(4.41±1.16)mmol/L,(1.35±0.67)mmol/L]were loweRthan those in the middle aged group[(4.94±1.06)mmol/L,(2.49±1.92)mmol/L]and those in the junioRyoung group[(5.00±1.30)mmol/L,(3.01±2.70)mmol/L];LDL cholesterol[(2.13±0.70)mmol/L]was lowerthan that in the junioRyoung group[(2.66±1.07)mmol/L](all P<0.05).Three months aftertreatment,levels of blood uric acid of the three groups were lowerthan before treatment(P<0.05),but there was no statistical significance between the three groups(P>0.05).Conclusion:Patients of different ages with metabolic arthritis have different clinical features,so they are supposed to be treated discriminately.