慢性肾脏病患者血尿酸水平变化及影响因素
|
摘要
目的探讨慢性肾脏病(CKD)患者血清尿酸水平变化及影响因素。方法回顾性分析明确诊断为CKD患者418例,依据肾脏功能分期分为5组。检测血清肌酐、血尿素氮、血尿酸及血脂水平,分析影响血尿酸水平的因素。结果 CKD患者肾小球滤过率GFR<60 mL/(min·1.73 m~2)组(3期、4期、5期)的血尿酸水平较GFR≥60 mL/(min·1.73 m~2)组(1期、2期)明显升高,差异有统计学意义(P<0.05);CKD血尿酸水平与GFR呈负相关性(r-0.355,P<0.05)。CKD的GFR <60 mL/(min·1.73 m~2)患者中高尿酸血症组与尿酸正常组相比,性别、合并糖尿病差异有统计学意义(P<0.05);高尿酸血症组较尿酸正常组甘油三酯水平升高,差异无统计学意义(P>0.05)。多因素Logistic回归分析显示,CKD的GFR<60 mL/(min·1.73 m~2)患者HUA的独立危险因素为性别、合并糖尿病、甘油三脂(P<0.05)。结论 CKD的GFR<60 mL/(min·1.73 m~2)患者血尿酸水平明显升高,与肾功能损害程度存在直线相关关系,性别、合并糖尿病、甘油三酯均是其发生的独立危险因素。
引文
[1] Zhou Y,Fang L,Jiang L,et al.Uric acid induces renal inflammation via activating tubular NF-κB signaling pathway[J].PLOS One,2012,7(6):e39738.
[2] Sánchez Lozada LG,Lanaspa MA,Cristóbal García M,et al.Uric acid-induced endothelial dysfunction is associated with mitochondrial alterations and decreased intracellular ATP concentrations[J].Nephron Experimental Nephrology,2012,121(3/4):71-78.
[3] Rabadi MM,Kuo MC,Galy T,et al.Interaction between uric acid and HMGB1 translocation and release from endothelial cells[J].American Journal of Physiology Renal Physiology,2012,302(6):730-741.
[4] Nymanu,Grubba,Sterner,et al.The CKD-EPI and MDRD equations to estimate GFR.Validation in the Swedish Lund-Malmo study cohort[J].Scandinavian Journal of Clinical and Laboratory Investigation,2011,71(2):129-138.
[5] 李青,潘洁敏,包玉倩,等.2型糖尿病肾脏疾病患者血尿酸水平与肾功能不全的相关性[J].上海医学,2013,36(1):59-62.
[6] Waring WS,Mcknighy JA,Webb DJ,et al.Uric acidrestores endothelial fuction in patients with type 1 diabetes and regular smokers[J].Diabetes,2006,55(11):3127-3132.
[7] Li ZB,Liu Qinghua,Mao HP,et al.Gender difference in the association of hyperuricemia with chronic kidney disease in southern China[J].Kidney & Blood Pressure Research,2012,36(1):98-106.
[8] Bangaru P,Shankar A.Association between Serum Uric Acid Levels and Diabetas Mellitus[J].International Journal of Endocrinology,2011,56(19):604.
[9] 何婷,黄玉宇,王红武,等.高龄住院患者血尿酸水平与慢性肾脏病的相关性研究[J].岭南急诊医学杂志,2017,22(4):347-349.
[10] 张振关,陈雪娇,卢燕红,等.糖尿病并发高尿酸血症与血脂及血压的相关性分析[J].中国实用医药,2014,9(28):22-23.
[2] Sánchez Lozada LG,Lanaspa MA,Cristóbal García M,et al.Uric acid-induced endothelial dysfunction is associated with mitochondrial alterations and decreased intracellular ATP concentrations[J].Nephron Experimental Nephrology,2012,121(3/4):71-78.
[3] Rabadi MM,Kuo MC,Galy T,et al.Interaction between uric acid and HMGB1 translocation and release from endothelial cells[J].American Journal of Physiology Renal Physiology,2012,302(6):730-741.
[4] Nymanu,Grubba,Sterner,et al.The CKD-EPI and MDRD equations to estimate GFR.Validation in the Swedish Lund-Malmo study cohort[J].Scandinavian Journal of Clinical and Laboratory Investigation,2011,71(2):129-138.
[5] 李青,潘洁敏,包玉倩,等.2型糖尿病肾脏疾病患者血尿酸水平与肾功能不全的相关性[J].上海医学,2013,36(1):59-62.
[6] Waring WS,Mcknighy JA,Webb DJ,et al.Uric acidrestores endothelial fuction in patients with type 1 diabetes and regular smokers[J].Diabetes,2006,55(11):3127-3132.
[7] Li ZB,Liu Qinghua,Mao HP,et al.Gender difference in the association of hyperuricemia with chronic kidney disease in southern China[J].Kidney & Blood Pressure Research,2012,36(1):98-106.
[8] Bangaru P,Shankar A.Association between Serum Uric Acid Levels and Diabetas Mellitus[J].International Journal of Endocrinology,2011,56(19):604.
[9] 何婷,黄玉宇,王红武,等.高龄住院患者血尿酸水平与慢性肾脏病的相关性研究[J].岭南急诊医学杂志,2017,22(4):347-349.
[10] 张振关,陈雪娇,卢燕红,等.糖尿病并发高尿酸血症与血脂及血压的相关性分析[J].中国实用医药,2014,9(28):22-23.