痛风患者合并高血压现状及其相关因素分析

目的 了解痛风患者合并高血压的现状，并分析其相关影响因素，为降低痛风合并高血压的患病风险提供科学依据。 方法 采用横断面研究的方法，收集2020年4月—2021年2月来自四川省成都市某风湿专科医院的581例痛风患者，调查其一般人口学特征、生活饮食行为方式，并对其进行体格检查及实验室指标检测。组间差异比较采用检验（或Fisher 精确概率法），痛风患者合并高血压的相关因素分析采用logistic回归模型，检验水准α= 0.05。 结果 581例痛风患者合并高血压者251例（43.2%）。男性567例（97.6%），女性14例（2.4%）。单因素分析结果显示，痛风患者合并高血压组与未合并高血压组的年龄、BMI、婚姻状况、痛风病程、痛风类型、痛风石、高强度体力活动、中等强度体力活动、胆固醇（CHOL）、肾小球滤过率（eGFR）、豆类及其制品摄入、红肉摄入、油炸食品摄入、甜品摄入、肉汤摄入的差异有统计学意义（均P＜0.05）。多因素分析结果显示，年龄（与＜40岁相比，40～49岁:OR = 3.41，95%CI:1.64～7.06；50～59岁:OR = 2.93，95%CI:1.28～6.68; ≥60岁:OR = 8.00，95%CI:2.75～23.29）、BMI（与18.5～23.9 kg/m2相比，≥28.0 kg/m2:OR = 3.69， 95%CI:1.96～6.98）、痛风病程（与＜1年相比，≥10年:OR = 2.38，95%CI:1.04～5.40）、CHOL（与＜5.2 mmol/L相比，5.2～6.19mmol/L:OR = 2.51， 95%CI:1.37～4.68）可能为痛风合并高血压的危险因素；饮茶（OR = 0.54，95%CI:0.32～0.93）、禽肉摄入（与≤1次/周相比，≥3次/周:OR = 0.45， 95%CI:0.26～0.79）可能为痛风合并高血压的保护因素。 结论 胆固醇水平较高、肥胖、痛风病程较长且年龄超过40岁可能为痛风合并高血压的独立危险因素。建议痛风患者坚持定期体检，适当增加体力活动，积极控制体重，改善膳食结构，增加优质动物蛋白摄入和适量饮茶。临床医生对痛风患者的日常诊疗中应加强对血脂、血压等指标监测，有利于预防和减缓痛风合并高血压的发生。

Current status and influencing factors for gout patients with hypertension

Objective To investigate the current status and influencing factors of gout patients complicated with hypertension, and to provide scientific strategies for reducing the incidence of gout patients with hypertension. Methods A cross-sectional study was conducted to collect 581 gout patients from a rheumatology hospital in Chengdu, Sichuan Province, from April 2020 to February 2021, to investigate their general demographic characteristics, lifestyle and dietary behaviors, and to perform physical examination and laboratory index tests. Differences between groups were compared using the test (or Fisher’s exact probability method), and the factors associated with combined hypertension in gout patients were analyzed using a logistic regression model with α test level of 0.05. Results There were 251 (43.2%) cases of combined hypertension in 581 gout patients. There were 567 male cases (97.6%) and 14 female cases (2.4%). The results of univariate analysis showed that the differences in age, BMI, marital status, duration of gout, type of gout, gout stones, high intensity physical activity, moderate intensity physical activity, cholesterol (CHOL), glomerular filtration rate (eGFR), intake of legumes and their products, red meat intake, fried food intake, dessert intake, and broth intake between the group of gout patients with combined hypertension and those without combined hypertension were statistically significant (all P<0.05). The results of multifactorial analysis showed that age (compared with <40 years, 40 to 49 years: OR=3.41, 95%CI: 1.64-7.06; 50 to 59 years: OR=2.93, 95%CI: 1.28-6.68; ≥60 years: OR=8.00, 95%CI: 2.75-23.29), BMI (compared with 18.5-23.9 kg/m2 compared to 18.5-23.9 kg/m2: OR=3.69, 95%CI: 1.96-6.98), duration of gout (≥10 years compared to <1 year: OR=2.38, 95%CI: 1.04-5.40), CHOL (5.2-6.19 mmol/L compared to <5.2 mmol/L: OR=2.51, 95%CI: 1.37-4.68) might be risk factors for gout combined with hypertension. Tea consumption (OR=0.54, 95%CI: 0.32-0.93) and poultry meat intake (≥3 times/week compared with ≤1 time/week: OR=0.45, 95%CI: 0.26-0.79) might be protective factors for gout combined with hypertension. Conclusion High cholesterol level, obesity, advanced duration of gout, and ≥ 40 years old are likely independent risk factors of gout complicated with hypertension. Patients with gout should have regular physical examinations, pay attention to daily physical activities, actively control body weight to normal level, improve dietary structure through increasing high quality animal protein intake and drinking tea properly. Clinicians should strengthen the monitoring of lipid and blood pressure indexes in the daily treatment of gout patients, which is helpful to prevent and slow down the occurrence of gout combined with hypertension.