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目的探讨血清尿酸水平与男性住院高血压患者药物降压治疗反应的关系。方法通过尿酸酶紫外法测定血清尿酸水平。入选2007-08-2009-09福建省立医院所有主要诊断为原发性高血压的男性患者804例,分为尿酸正常组(血清尿酸水平<420μmol/L,n=499)和高尿酸血症组(血清尿酸水平≥420μmol/L,n=305),运用多元回归分析的方法,分析年龄、糖尿病、慢性肾脏病等危险因素与血尿酸的关系,探讨尿酸水平与血压下降幅度的关系。结果高尿酸血症组体质量指数(BMI)、收缩压、血清肌酐、降压药物种类及剂量高于尿酸正常组(均P<0.05),而估计的肾小球滤过率(eGFR)[(68.4±24.1)比(82.5±21.3)mL/(min.1.73m2)]及出院血压达标率(41.6%比50.7%)低于尿酸正常组(均P<0.05);经校正年龄、收缩压或舒张压、糖尿病史、吸烟史、家族史、BMI、血脂代谢异常、住院时间、药物降压强度及慢性肾脏病后,高尿酸血症组较尿酸正常组的收缩压下降幅度减少5.20mmHg(95%CI-7.30～-3.11);舒张压下降幅度减少1.55mmHg(95%CI-2.88～-0.22)。结论血清尿酸水平升高可影响住院男性高血压患者对降压药物治疗的疗效,使疗效降低。
Objective To investigate the relationship between serum uric acid level and antihypertensive treatment response in male hospitalized hypertensive patients. Methods Serum uric acid levels were determined by uricase UV. Selected from 2007-08-2009-09 Fujian Provincial Hospital, all major diagnosed as essential hypertension in 804 male patients, divided into normal uric acid group (serum uric acid levels <420μmol / L, n = 499) and hyperuricemia (Serum uric acid level≥420μmol / L, n = 305). The relationship between serum uric acid and risk factors such as age, diabetes, chronic kidney disease and serum uric acid was analyzed by multivariate regression analysis. Results The body mass index (BMI), systolic blood pressure, serum creatinine, antihypertensive drugs and dosage in hyperuricemia group were higher than those in normal uric acid group (all P <0.05), but the estimated glomerular filtration rate (eGFR) (68.4 ± 24.1) vs (82.5 ± 21.3) mL / (min.1.73m2), and blood pressure compliance rate (41.6% vs. 50.7%) were lower than those in the normal uric acid group (all P <0.05) Or diastolic blood pressure, diabetes history, smoking history, family history, BMI, dyslipidemia, length of hospital stay, drug antihypertensive intensity and chronic kidney disease, the reduction in systolic blood pressure in hyperuricemia group was 5.20mmHg 95% CI-7.30 ~ -3.11). The decrease of diastolic blood pressure was reduced by 1.55mmHg (95% CI-2.88-0.22). Conclusion The elevated serum uric acid levels may affect the efficacy of antihypertensive drugs in hospitalized male patients with hypertension and reduce the therapeutic effect.