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目的研究某部干部血尿酸及肾脏排泄尿酸变化的影响因素,查找尿酸升高的可能危险因素,为控制尿酸提供指导依据。方法利用年度干部体检对某部参加体检的非痛风和尿酸未受明确因素影响的1 096人进行问卷调查,及血生化等检查,并计算体质指数、尿白蛋白肌酐比、尿酸-肌酐廓清率比值。以男性血尿酸>420μmol/L(7.0 mg/dL)、女性血尿酸>357μmol/L(6.0 mg/dL)为高尿酸血症组,余为非高尿酸血症组;以尿酸-肌酐廓清率比值由低到高分为尿酸低排组、混合组和尿酸高排组。汇总数据后进行统计学分析。结果男性血尿酸明显高于女性[(330.9±69.4)mmol/L与(249.4±55.2)mmol/L)];高尿酸血症患病率男性与女性无明显差别。高尿酸血症组体质指数、收缩压、舒张压、三酰甘油、血肌酐、尿素氮、高敏C反应蛋白、同型半胱氨酸、尿白蛋白肌酐比、腰围、臀围均明显高于非高尿酸血症组,而高密度脂蛋白、尿酸-肌酐廓清率比值明显低于非高尿酸血症组。高尿酸血症与体质指数、三酰甘油、血肌酐、高敏C反应蛋白、尿白蛋白肌酐比、尿酸-肌酐廓清率比值密切相关,其中尿酸-肌酐廓清率比值、三酰甘油、体质指数为重要影响因素。血尿酸与三酰甘油、体质指数、腰围、臀围、舒张压呈正相关,与尿酸-肌酐廓清率比值呈负相关。尿酸-肌酐廓清率比值与三酰甘油呈显著负相关。性别、三酰甘油、血肌酐、尿酸和尿白蛋白肌酐比对尿酸-肌酐廓清率比值有影响,其中三酰甘油和尿酸对尿酸-肌酐廓清率比值存在负性影响。结论血尿酸变化受多种因素影响,可改变的影响因素集中于肾脏排泄能力、三酰甘油和体质量,应作为防治高尿酸血症的重点。
Objective To study the influencing factors of uric acid excretion and excretion of uric acid in a cadre, find out the possible risk factors of uric acid exacerbation, and provide guidance for the control of uric acid. Methods A total of 1 096 non-gout and uric acid patients who did not receive the specific factors of uterine bleeding and uric acid were investigated by questionnaire and blood biochemistry examination using the annual physical examination. The body mass index, urinary albumin creatinine ratio, uric acid-creatinine clearance rate ratio. The patients with hyperuricemia were divided into two groups according to the serum uric acid> 420μmol / L (7.0 mg / dL), female uric acid> 357μmol / L (6.0 mg / dL) Ratio from low to high uric acid into low-row group, mixed group and high-uric acid group. The data were aggregated for statistical analysis. Results The serum uric acid was significantly higher in males than in females [(330.9 ± 69.4) mmol / L and (249.4 ± 55.2) mmol / L)]. The prevalence of hyperuricemia was not significantly different between males and females. Hyperuricemia group body mass index systolic blood pressure, diastolic blood pressure, triglyceride, serum creatinine, urea nitrogen, high-sensitivity C-reactive protein, homocysteine, urinary albumin creatinine ratio, waist circumference, In the group of hyperuricemia, the ratio of high density lipoprotein and uric acid - creatinine was significantly lower than that of non - hyperuricemia group. Hyperuricemia and body mass index, triglyceride, serum creatinine, high-sensitivity C-reactive protein, urinary albumin creatinine ratio, uric acid - creatinine clearance rate was closely related to the uric acid - creatinine clearance ratio, triglyceride, body mass index Important influencing factors. Serum uric acid and triglyceride, body mass index, waist circumference, hip circumference, diastolic blood pressure was positively correlated with uric acid - creatinine clearance rate was negatively correlated. The ratio of uric acid to creatinine clearance rate was negatively correlated with triglyceride. Sex, triglyceride, serum creatinine, uric acid and urinary albumin creatinine ratio of uric acid - creatinine clearance ratio have an impact, including triglyceride and uric acid on uric acid - creatinine clearance rate of negative impact. Conclusion The changes of serum uric acid are influenced by many factors. The influential factors that can be changed are renal excretion, triglyceride and body weight, which should be the focus of prevention and treatment of hyperuricemia.