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目的分析广西三县痛风患者的血脂水平现状及影响因素,为痛风疾病的治疗与预防提供参考依据。方法采用1:1配对的病例-对照研究方法,在广西大化、三江县、合浦县开展相关研究,以2015年5月以县级及县级以上医院确诊的痛风病例作为痛风组(379例),病例选定后,根据痛风组病例的基本信息,在对应病例的同一社区/村屯选出所有与患者同性别、年龄相近、无血缘关系且居住的非痛风、非高尿酸血症者作为健康组(379例),共758例。收集研究对象的一般情况、体格检查、实验室检验等数据,并进行单因素和多因素的Logistic回归分析。结果痛风组患者血脂异常检出率为57.5%,混合型血脂异常检出率为38.3%,痛风组与对照组间血脂异常、混合型血脂异常、高甘油三酯(TG)、高总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、血尿酸(UA)、TG、TC、HDL-C水平比较差异均有统计学意义(P<0.05);痛风组患者中的血脂正常组与异常组间UA、TG、TC、HDL-C、体重、BMI、腰围、收缩压、舒张压、血糖水平比较差异均有统计学意义(P<0.05);超重、肥胖、高尿酸、高血压是痛风患者高TG的主要影响因素(OR值分别为2.226、6.667、2.900、1.727);脂肪是高TC的主要影响因素(OR=1.093);超重、肥胖、高尿酸是血脂异常的主要影响因素(OR值分别为2.923、5.479、2.157);肥胖、高尿酸、高血压是混合型血脂异常的主要影响因素(OR值分别为4.052、2.257、1.649)。结论痛风患者的血脂异常率处于较高水平,对于痛风合并血脂异常的患者,应考虑血脂对痛风疾病的影响,改善血脂水平,达到治疗和预防痛风的目的。
Objective To analyze the status and influencing factors of blood lipid levels in gout patients in three counties of Guangxi and provide reference for the treatment and prevention of gout diseases. Methods A 1: 1 matched case-control study was conducted in Dahua County, Sanjiang County and Hepu County of Guangxi Province. Gout cases confirmed by county and county hospitals were selected as gout group (379 cases ), Selected cases, according to the basic information gout group of patients, in the same case corresponding to the same community / village selected all patients with the same sex, age, non-related and living non-gout, non-hyperuricemia As a healthy group (379 cases), a total of 758 cases. The general conditions of the study subjects, physical examination, laboratory tests and other data were collected, and single factor and multivariate Logistic regression analysis. Results The prevalence of dyslipidemia in gout group was 57.5%, the prevalence of mixed dyslipidemia was 38.3%, the levels of dyslipidemia, mixed dyslipidemia, triglyceride (TG), high total cholesterol ( TC, HDL-C, UA, TG, TC and HDL-C were significantly different between the two groups (P <0.05) There were significant differences in UA, TG, TC, HDL-C, body weight, BMI, waist circumference, systolic blood pressure, diastolic blood pressure and blood glucose among the abnormal group (P <0.05) The main influencing factors of high TG in patients with gout (OR = 2.226,6.667,2.900,1.727, respectively); fat was the main influencing factor of high TC (OR = 1.093); overweight, obesity and hyperuricemia were the main influencing factors of dyslipidemia OR values were 2.923,5.479,2.157 respectively). Obesity, hyperuricemia and hypertension were the main influencing factors of mixed dyslipidemia (OR = 4.052,2.257,1.649, respectively). Conclusions The rate of dyslipidemia in patients with gout is at a high level. Patients with gout and dyslipidemia should consider the effect of blood lipids on gout disease, improve blood lipid levels, and achieve the goal of treatment and prevention of gout.