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目的:比较原发性醛固酮增多症(PA)和原发性高血压(EH)患者血尿酸水平的差异,探讨血尿酸水平与肾脏早期损害的关系。方法:选择因“高血压查因”住院确诊的资料完整的病例,按性别、年龄、高血压水平及其病程等匹配原则纳入117例PA患者和117例EH患者,比较两组患者血脂、血糖、血尿酸等代谢紊乱程度和肾靶器官损害的差异。结果:(1)PA患者尿酸水平显著低于EH患者[(314.00±89.52)μmol/L vs(379.16±101.25)μmol/L,P<0.01],但其尿微量白蛋白排泄率(UAER)显著高于EH患者[18.65(9.58,35.99)μg/min vs 9.00(4.53,18.70)μg/min,P<0.01],两组患者e GFR、肌酐、尿素氮水平无显著差异(P>0.05)。(2)高尿酸血症的PA患者与正常尿酸水平的PA患者之间UAER、肌酐、尿素氮、e GFR水平无显著差异(均P>0.05);高尿酸血症的EH患者较正常尿酸水平的EH患者UAER、肌酐、尿素氮升高,而e GFR水平下降(均P<0.05)。(3)多重线性回归分析显示在校正年龄、病程、BMI后,PA患者的卧位醛固酮水平、入院收缩压对其UAER有独立预测价值(P<0.05),但尿酸对UAER无影响(P>0.05);EH患者尿酸及入院收缩压均对其UAER有独立预测价值(P<0.05)。结论 PA患者尿酸水平较EH患者低。PA患者血尿酸水平与其肾脏早期损害无相关性,而EH患者血尿酸水平与肾脏早期损害有关。
Objective: To compare the difference of serum uric acid between patients with primary aldosteronism (PA) and essential hypertension (EH) and to investigate the relationship between serum uric acid level and early renal damage. Methods: One hundred and seventy patients with PA and 117 patients with EH were enrolled according to the matched data of sex, age, hypertension, and course of disease. , Blood glucose, serum uric acid and other metabolic disorders and the difference between the target organ damage. Results: (1) The uric acid level in patients with PA was significantly lower than that in patients with EH [(314.00 ± 89.52) μmol / L vs (379.16 ± 101.25) μmol / L, P <0.01], but the urinary albumin excretion rate The levels of eGFR, creatinine and urea nitrogen in the two groups were significantly higher than those in EH patients [18.65 (9.58, 35.99) μg / min vs 9.00 (4.53, 18.70) μg / min, P <0.01]. (2) There was no significant difference in UAER, creatinine, urea nitrogen, e GFR between PA patients with hyperuricemia and PA patients with normal uric acid levels (all P> 0.05); patients with hyperuricemia had higher uric acid levels UAER, creatinine and urea nitrogen increased, while e GFR level decreased in EH patients (all P <0.05). (3) Multiple linear regression analysis showed that aldosterone level and admission systolic blood pressure in patients with PA had independent predictive value (P <0.05), but uric acid had no effect on UAER after adjusting for age, course of disease and BMI (P> 0.05). UA and systolic blood pressure in patients with EH had independent predictive value for UAER (P <0.05). Conclusion PA patients with lower uric acid levels than EH patients. There was no correlation between serum uric acid level and early renal damage in patients with PA, while serum uric acid levels in EH patients were related to early renal damage.