无症状高尿酸血症患者强化治疗血尿酸目标值的探索性研究

Exploratory study on target value of blood uric acid in asymptomatic hyperuricemia patients with intensive treatment

目的探讨强化治疗方案治疗无症状高尿酸血症(HUA)的安全性及对颈动脉内膜中层厚度(CIMT)的影响。方法根据不同血尿酸(SUA)控制目标将2020年9月至2021年3月该院就诊和体检的204例HUA患者随机分为标准治疗组和强化治疗组,每组102例。对2组患者管理和随访12个月。统计分析2组患者年龄、性别、体重指数、血压、尿pH值、三酰甘油、低密度脂蛋白胆固醇、SUA、肾小球滤过率估计值、CIMT、药物不良反应发生率等。结果2组患者性别、年龄、体重指数、吸烟、饮酒、SUA、尿pH值、三酰甘油、总胆固醇、低密度脂蛋白胆固醇、肾小球滤过率估计值、收缩压、舒张压、治疗前CIMT比较,差异均无统计学意义(P>0.05)。强化治疗组患者治疗后CIMT明显降低,差异有统计学意义(P<0.05);标准治疗组患者治疗后CIMT与治疗前比较,差异无统计学意义(P>0.05);2组患者不良反应发生率比较,差异无统计学差异(P>0.05)。结论强化治疗方案与标准治疗方案的安全性相似,但在改善HUA患者CIMT方面,强化治疗方案优于标准治疗方案。

Objective To explore the safety of intensive treatment for asymptomatic hyperuricemia(HUA)and its effect on carotid intima-media thickness(CIMT).Methods According to different control targets of serum uric acid(SUA),204 patients with HUA who met the criteria of nanofiltration were randomly divided into the standard treatment group and the intensive treatment group,and the patients were managed and followed up for 12 months.Statistical analysis was conducted on the patient′s age,sex,body mass index,blood pressure,urine PH value,total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),blood uric acid,estimated glomerular filtration rate(eGFR),CIMT,and adverse drug reaction rate.Results There were no significant differences between the two groups in gender,age,body mass index,smoking,drinking,SUA,urine PH,TG,TC,LDL,eGFR,systolic blood pressure,diastolic blood pressure and CIMT value before treatment(P>0.05);The CIMT after treatment was significantly lower than that before treatment in the intensive treatment group(P<0.05),The CIMT after treatment was not significantly lower than that before treatment in the standard treatment group(P>0.05);The incidence of adverse drug reactions in the standard treatment group and the intensive treatment group respectively,with no statistical difference(P>0.05).Conclusion The safety of intensive treatment scheme is similar to that of standard treatment scheme.However,in terms of improving CIMT of patients with HUA,the intensive treatment scheme is superior to the standard treatment scheme.