摘要
目的 观察尿酸(uria acid, UA)对克罗恩病(Crohn’s disease, CD)患者肾功能的影响。方法 回顾性分析2019年同济大学附属第十人民医院170例住院CD患者的资料,根据首次随访时UA值(>420μmol/L)分UA升高组和UA正常组。单因素分析2组患者临床特征;多元线性回归分析影响估算肾小球滤过率(estimated glomerular filtration rate, eGFR)的因素。Logistics多元回归分析随访期间发生eGFR下降>20 mL/(min·1.73 m^(2))的危险因素。Kaplan-Meier分析2组患者发生eGFR下降>20 mL/(min·1.73 m^(2))的累积概率,Cox回归分析生存曲线差异。结果 UA升高组(n=60)较正常组(n=110)患者年龄更大[(34.47±1.10)岁vs(30.87±1.54)岁,P=0.038],男性患者(88.33%vs 58.18%,P<0.01)更多、回肠型(25.00%vs 12.73%,P=0.035)更多,而结肠型更少(15.00%vs 35.45%,P=0.035)。UA升高组首次随访[(111.96±2.35) mL/(min·1.73 m^(2))vs(119.38±1.56) mL/(min·1.73 m^(2)),P=0.008]和1年后[(112.32±2.11) mL/(min·1.73 m^(2))vs(119.33±1.50) mL/(min·1.73 m^(2)),P=0.009]的eGFR值均低于UA正常组。多元线性回归分析显示高龄、高UA是低eGFR的危险因素(P<0.05)。Kaplan-Meier分析显示UA升高组eGFR下降>20 mL/(min·1.73 m^(2))的累积发生概率高于UA正常组(P=0.048)。Cox回归分析显示UA水平高为1年内eGFR下降>20 mL/(min·1.73 m^(2))的危险因素(P<0.05)。结论 年龄增长和高UA为CD患者肾功能进展的危险因素。
Objective Aims To investigate the association between serum uric acid(UA) level and renal function in patients with Crohn disease(CD). Methods Clinical data of 170 patients diagnosed with CD at Department of Gastroenterology, Shanghai Tenth People’s Hospital in 2019 were retrospectively analyzed. There were 60 cases with elevated UA(elevated UA group) and 110 cases with normal UA(normal UA group). The relationship between serum UA level and clinical characteristics of patients were analyzed with univariate and multivariate logistics regression, Kaplan-Meier method and Cox regression. Results Compared with normal UA group, the elevated UA group had older mean age [(34.47±1.10) years vs(30.87±1.54) years, P=0.038], lower proportion of colonic phenotype(15.00% vs 35.45%, P=0.035), higher proportion of males(88.33% vs 58.18%, P<0.01) and more ileum involvement(25.00% vs 12.73%, P=0.035). The eGFR in the elevated UA group was lower than that in the normal UA group at the baseline [(111.96±2.35) mL/(min·1.73 m^(2)) vs(119.38±1.56) mL/(min·1.73 m^(2)), P=0.008] and after 1 year of follow-up [(112.32±2.11) mL/(min·1.73 m^(2)) vs(119.33±1.50) mL/(min·1.73 m^(2)), P=0.009]. The probability for cumulative occurrence of eGFR decreased >20 mL/(min·1.73 m^(2)) within 1 year in elevated UA group were higher than that in normal UA group(P=0.048). Older age, elevated UA were risk factors of lower eGFR(P<0.05);and elevated UA was risk factor for probability of eGFR decreased >20 mL/(min·1.73 m^(2)) cumulative occurrence within 1 year(P<0.05). Conclusion Old age and elevated UA levels are risk factors of decreased renal function in patients with CD.
作者
李婷
汪海潮
顾宏晨
王菱
陈美含
彭艾
陈春球
LI Ting;WANG Haichao;GU Hongchen;WANG Ling;CHEN Meihan;PENG Ai;CHEN Chunqiu(Department of Nephrology,Shanghai Tenth People's Hospital,School of Medicine,Tongji University,Shanghai 200072,China;School of Medicine,Tongji University,Shanghai 200092,China;Diagnostic and Treatment Center for Refractory Diseases of Abdomen Surgery,Shanghai Tenth People's Hospital,School of Medicine,Tongji University,Shanghai 200072,China)
出处
《同济大学学报（医学版）》
2022年第3期349-354,共6页
Journal of Tongji University(Medical Science)
基金
国家自然科学基金(81970756)
国家自然科学基金青年项目(82000833)。
关键词
尿酸
肾功能
克罗恩病
uric acid
renal function
Crohn disease
