肝硬化患者血尿酸水平的变化及其意义

Changes of Blood Uric Acid and Its Significance in Patients with Liver Cirrhosis

目的 :探讨肝硬化患者血尿酸 (UA)水平的变化及其意义。方法 :回顾性分析我院肝硬化住院患者 (摒除患有可能影响UA代谢的疾病或服用影响UA代谢的药物的患者 ) 4 2例作为研究对象。分析其UA水平的变化及UA与多种可能影响因素如年龄、性别、腹水、肝功能分级、血肌酐 (Cr)、血直接胆红素 (D BIL)等的关系。同时按上述标准选取年龄、性别无差异的对照者 42例。结果 :UA值不存在年龄、性别的差异 (P >0 .0 5 )。总UA均值为 2 2 8.2 8± 13 6.83 μmol/L ,明显低于对照组 (P <0 .0 1) ;D BIL均值为 3 1.83± 46.0 1μmol/L ,显著高于对照组 (P <0 .0 1) ;Cr均值为 90 .41±83 .43mmol/L ,与对照组差异无显著性 (P >0 .0 5 ) ;Pugh Child分级分数均值为8.86± 2 .3 1,明显高于对照组 (P <0 .0 1)。UA正常 2 8例 ,降低 12例 ,升高 2例。UA正常组与其余 2组间UA值有显著性差异 (P <0 .0 1) ,UA降低组与正常组间D BILPugh Child分级分数有显著性差异 (P各 <0 .0 5与 <0 .0 1) ,而三组间年龄、Cr均值无显著性差异 (P >0 .0 5 )。Pugh Child分级C级患者的UA值明显低于A级的患者 (P <0 .0 5 ) ;有腹水与无腹水组间的UA值无显著性差异 (P >0 .0 5 )。多因素相关分析表明UA与年龄、D BIL、Cr及Pugh Child分级分数均无?

Objective: To explore the changes and significance of blood uric acid (UA) level in patients with liver cirrhosis. Methods: 42 hospitalized patients who were diagnosed with liver cirrhosis were retrospectively analyzed (diseases and drugs which may affecting the UA metabolism were excluded). The changes of blood UA and the relationship between UA and its possible affecting factors such as age, sex, ascites, liver functional classification, serum creatinine(Cr) and blood direct bilirubin (D-BIL) were analyzed. 42 cases with matched age and sex were as the control. Results: There is no difference in age and sex in respect to the UA concentration. The total mean value of blood UA in patients with liver cirrhosis is 228.28± 136.83 μmol/L, which is significantly lower than that of control group(P< 0.01);the mean value of D-BIL is 31.83± 46.01 μmol/L, which is significantly higher than that of control group(P< 0.01).The mean value of serum creatinine (Cr)is 90.14± 83.43 mmol/L, which showed no significant difference(P< 0.05) compare to the control group. Among 42 cirrhotic patients, the level of blood UA is normal in 28, high in 2 and low in 12 cases. There was significant difference in the value of UA between the normal UA group and the other 2 groups. But the D-BIL and Pugh-child classification in cases with decreased UA were significantly different from normal UA group(P< 0.05 and < 0.01). but there was no significant difference in ages, sex, creatinine level among the three groups. The level of UA in cases whose liver functional classification belong to C was lower than A group significantly(P< 0.05). The value of UA in patients with ascites had no distinct difference from those without ascites. The results of multiple factor correlation analysis showed no correlation between blood UA and age, sex, ascites, liver functional classification, etiology, serum Cr and blood D-Bil. Conclusion: The level of UA in patients of Push-Child C was significantly lower than that of A group.It is suggested that UA negatively correlate with severity of hepatic cirrosis.