摘要
目的探讨住院痛风患者并发慢性肾病的危险因素。方法住院痛风患者537例,根据肾小球滤过率(eGFR)水平(>90 ml/min、60~90 ml/min和<60 ml/min)分为正常肾功能组、轻度肾功能不全组(CKD)、中重度肾功能不全组(中重度CKD)。测量身高、体重、腰围、臀围、血压。抽取肘静脉血测生化指标。留取24 h尿,测肌酐、尿酸。对于可能影响eGFR的相关因素进行多因素回归分析。结果慢性肾功能不全总患病率、轻度CKD和中重度CKD患病率分别为46.74%(251/537)、34.82%(187/537)、11.92%(64/537)。随着eGFR的下降,患者年龄越大,痛风和高血压病程越长,受累关节数越多,血尿酸、尿微量白蛋白、尿蛋白、血白细胞计数、尿酸排泄分数(FeUA)呈升高趋势,红细胞计数、血红蛋白、血白蛋白呈下降趋势。eGFR的Pearson相关性分析显示,年龄、痛风及高血压病程、受累关节数、血红蛋白、血白蛋白、血尿酸、尿微量白蛋白、FeUA与eGFR呈相关性(r=-0.43、-0.238、-0.25、-0.128、0.155、0.138、-0.169、-0.29、-0.372,P<0.01)。多因素回归分析显示,年龄、痛风病程、血尿酸、尿微量白蛋白、FeUA是eGFR下降的独立危险因素(P<0.01)。结论高龄、长病程、血尿酸控制差及尿尿酸、尿微量白蛋白排泄增多是痛风发生慢性肾病的危险因素。
Objectives To analyze the prevalence and risk factors of chronic nephropathy among hospitalized gout patients.Methods 537 hospitalized gout patients in Tianjin Medical University Chu Hsien-I Memorial Hospital were enrolled.According to the levels of glomerular filtration rate(eGFR>90 ml/min,60-90 ml/min and<60 ml/min),patients were divided into normal group,mild chronic nephropathy group and moderate-severe chronic nephropathy group.The height,weight,waist,hip and blood pressure of the patients were measured.Blood samples from elbow vein were collected to measure biochemical indexes.The 24-hour urine was collected to measure creatinine and uric acid.Multivariate regression analysis was used to analyze the related factors that may affect eGFR.Results The prevalence of chronic nephropathy among gout patients was 46.76%(251/537),which the prevalence of mild chronic nephropathy was 34.82%(187/537),and moderate severe chronic nephropathy was 11.92%(64/537).With the decline of eGFR,the older the patients,the longer the course of gout and hypertension,the more the number of joints involved,the higher the blood uric acid,urinary microalbumin,urinary protein,white blood cell count,uric acid excretion fraction(FeUA),and the lower the red blood cell count,hemoglobin and serum albumin.Pearson correlation analysis of eGFR showed that age,duration of gout and hypertension,number of involved joints,hemoglobin,serum albumin,serum uric acid,urinary microalbumin,and FeUA were correlated with eGFR(r=-0.43,-0.238,-0.25,-0.128,0.155,0.138,-0.169,-0.29,-0.372,respectively,P<0.01).Multivariate regression analysis showed that age,the course of gout,serum uric acid,microalbuminuria and FeUA were independent risk factors for eGFR decline(P<0.01).Conclusions Eldly,long course of gout,poor control of serum uric acid and increased excretion of uric acid and microalbumin are risk factors of gout.
作者
聂秀玲
宋林凌
李明珍
孙丽荣
赵伟
Nie Xiuling;Song Linling;Li Mingzhen;Sun Lirong;Zhao Wei(NHC Key Laboratory of Hormones and Development(Tianjin Medical University),Tianjin Key Laboratory of Metabolic Diseases,Tianjin Medical University Chu Hsien-I Memorial Hospital&Tianjin Institute of Endocrinology,Gout Department,Tianjin 300134,China)
出处
《中国医师杂志》
CAS
2021年第5期707-710,715,共5页
Journal of Chinese Physician
关键词
痛风
肾功能不全
慢性
尿酸
因素分析
Gout
Renal insufficiency,chronic
Uric acid
Factor analysis
