老年高血压合并糖尿病患者血尿酸水平的临床观察

目的探讨老年高血压、糖尿病及高血压合并糖尿病患者的血尿酸(UA)水平。方法随机选择老年男性高血压36例、糖尿病33例、高血压合并糖尿病患者41例,对照组27例,比较4组血UA水平。结果3个试验组与对照组比较,血UA水平均明显升高,高血压合并糖尿病组差异显著(P<0.01);高血压合并糖尿病组与高血压组、糖尿病组比较均有显著性差异(P<0.01);高血压组与糖尿病组间无显著性差异。结论血UA水平与高血压、糖尿病密切相关。监测血UA水平有利于及时对原发病进行有效干预并改善其预后。     

血清尿酸与四年后血压变化及高血压发病的关系

目的 探讨中年人群血清尿酸（SUA）与四年后血压变化及高血压（HYP）发病的关系。方法 在1984年在基线调查的35－39岁血压正常（低于235／85mmHg）、有SUA值的1656名男女中,1988年有1480人（男性609,女性871）参加了复查,以此为队列人群,观察高血压的发病率及血压变化。结果 随访四年高血压发病率为13．1％。无论男女,按尿酸四分位分析显示高血压发病率随分位数增加而升高。多元Logistic回归分析,当控制年龄后在男性UA增加1个标准差（1．14mg/dl）是显著地增加HYP发病危险（HYP发病相对危险RR＝1．40,95％可信限1．12－1．74）。当BMI、吸烟、饮酒和基线SBP加入模型,SUA与HYP发病的关系减弱但仍有统计学显著性（RR＝1．28,95％可信限1．01－1．61）。多元线性回归分析,在男性基线年龄、SUA、BMI、和体重变化与4年的SBP变化呈正的显著关联。在女性SUA与高血压发病及血压变化均无显著关联。结论 结果表明在男性SUA对血压升高及高及高血压发病是个独立于体重指数（BMI）、吸烟和饮酒的危险因素。     

中老年人血尿酸水平与非酒精性脂肪性肝病的相关性研究

目的:研究中老年人群血尿酸水平与非酒精性脂肪性肝病(NAFLD)的相关性。方法 :采取整群抽样方法,对上海市嘉定社区2 519名40岁以上常住居民进行问卷调查、体格检查,同时采血进行血尿酸、血糖、血脂、肝功能、肾功能检测,以及上腹部彩色多普勒超声检查。NAFLD的诊断依据高分辨率超声扫描结果。按照血尿酸水平四分位数将研究人群分为Q1、Q2、Q3、Q4四组,并对其各项代谢指标进行分析。结果:NAFLD组的血尿酸水平显著高于非NAFLD组[(319.6±92.3)比(272.8±88.8)μmol/L,P<0.05)。结论:上海城镇中老年人群NAFLD患病风险随着血尿酸水平升高而增加。     

老年高血压患者动态脉压与血尿酸和超敏C反应蛋白的关系

目的探讨老年原发性高血压(EH)患者动态脉压(APP)与血尿酸(UA)、超敏C反应蛋白(hsCRP)水平的关系。方法入选112例老年EH患者,根据24 h动态血压监测结果计算APP,按照APP水平分为:30 mmHg≤APP60 mmHg组(PP1组)52例和APP≥60 mmHg组(PP2组)60例。分别测定2组的血清UA、hsCRP水平及相关临床生化指标,并进行比较。结果 PP2组的24 h平均收缩压(24hMSBP)显著高于PP1组(P0.05),24 h平均舒张压(24hMDBP)显著低于PP1组(P0.05);与PP1组相比,PP2组的血UA、hs-CRP水平显著升高,分别为(371.63±86.85)μmol/L和(311.25±74.36)μmol/L(P0.05)、(4.19±1.85)mg/L和(2.23±1.53)mg/L(P0.01)。相关性分析显示血UA、hs-CRP水平与APP均显著相关(P0.05或P0.01)。结论血UA、hs-CRP水平与APP关系密切,可能参与了老年EH患者脉压升高的病理生理过程。     

老年高血压患者颈动脉硬化与C-反应蛋白、血尿酸和补体的相关性

目的比较老年高血压患者血清C-反应蛋白（CRP）、血尿酸（UA）水平、补体C3与血压及颈动脉硬化程度的相关性。方法将132例老年高血压患者按血压值的不同分为3组，比较各组间CRP、UA与血压的相关性，对各组患者分别检测血生化指标：血清CRP、UA、补体C3，B超观察颈动脉内膜变化，按B超结果将患者分为内膜正常组、内膜增厚组、斑块形成组和管腔狭窄组，各组间CRP、UA、C3水平。结果高血压3级患者CRP、UA显著高于高血压1级、2级患者，差异有统计学意义（P〈0．05）。3组高血压患者CRP、UA值各组间比较差异有统计学意义（P〈0.05）。颈动脉内膜异常组CRP、UA、补体C，值明显高于内膜正常组，差异有统计学意义（P〈0．01）。随着颈动脉内膜-中层厚度（IMT）的增加，UA、CRP的浓度亦逐渐增高；颈动脉内膜异常组各组间比较差异均有显著性（P〈0．05）。结论老年高血压患者颈动脉硬化程度与血压、UA、CRP和补体C3浓度密切相关。老年高血压患者血压、CRP、UA浓度与IMT呈正相关关系（P〈0．01）。     

Related factors of serum uric acid in patients with primary hypertension and hyperhomocysteinemia

Objective: To investigate the related factors of serum uric acid in patients with primary hypertension and hyperhomocysteinemia. Methods: One hundred and ten patients with primary hypertension and hyperhomocysteinemia (homocysteine levels >10 μmol/L) were enrolled into this study, ages from 18 years to 75 years. They were divided into the normal serum uric acid group which contained 74 cases patients (41 cases of male and 33 cases of female) and the hyperuricemia group which contained 36 cases patients (20 cases of male and 16 cases of female). Plasma concentrations of homocysteine, serum uric acid, serum folic acid, blood sugar, triglyceride, total cholesterol, serum low density lipoprotein cholesterol, serum high density lipoprotein cholesterol, blood urea nitrogen, and creatinine were detected in these patients, and the deference of them between the two groups was compared. And then the risk factors of serum uric acid with univariate analysis and multivariate analysis by logistic regression analysis were analyzed. Results: The result of multivariate analysis showed that the incidence of serum uric acid in patients with primary hypertension and hyperhomocysteinemia had significant relationships with systolic blood pressure (OR [odds ratio]: 1.132, 95%CI [confidence interval]: 1.003~1.290, p = 0.043), diastolic blood pressure (OR: 1.353 95%CI: 1.023~1.789, p = 0.034, homocysteine (OR: 1.264, 95%CI: 1.016~1.573, p = 0.035), triglyceride (OR: 9.726, 95%CI: 1.288~73.466, p = 0.027), and creatinine (OR: 1.031, 95%CI: 1.005~1.508, p = 0.018). Conclusion: The indices of systolic blood pressure, diastolic blood pressure, homocysteine, triglyceride, and creatinine were important risk factors of serum uric acid in patients with primary hypertension and hyperhomocysteinemia. It is of great significance to measure multiple risk factors in patients with primary hypertension and hyperhomocysteinemia.     

老年高血压患者血尿酸水平与高血压危险因素的关系

目的研究血尿酸水平与高血压危险因素的关系,探讨血尿酸水平对高血压发生的预测价值。方法选择老年高血压患者230例(高血压组)及健康体检者202例(对照组)。根据血尿酸水平,按四分位法,将所有入选者分为≤288 μmol/L分位108例、289～333 μmol/L分位109例、334～386 μmol/L分位108例、≥387 μmol/L分位107例。分析血尿酸与高血压患病率及部分高血压危险因素是否有相关性。结果高血压组患者血尿酸水平明显高于对照组(P0.01);老年高血压患者血尿酸水平升高与体重指数、总胆固醇和高密度脂蛋白胆固醇密切相关(P0.01);老年高血压患病率与血尿酸水平同步升高;logistic回归分析显示,血尿酸水平和体重指数是老年高血压发病的独立危险因素之一(OR=1.006.95% CI:1.002～1.009,P0.05;OR=1.1 66,95% CI:1.047～1.298,P0.05)。结论高尿酸血症与多种高血压危险因素具有密切关系,是高血压发病的独立危险因素。     

心血管高危患者踝臂指数与血尿酸水平的相关性分析

目的探讨心血管高危患者踝臂指数与血尿酸水平的相关性。方法选取高血压和(或)糖尿病患者363例,将单纯原发性高血压189例作为高血压组、原发性高血压合并2型糖尿病123例作为合并组和单纯2型糖尿病51例作为糖尿病组,均常规治疗,检测患者踝臂指数(ABI)、血尿酸和其他心血管疾病危险因素,并应用偏相关分析血尿酸、ABI与其他临床指标相关性。结果 3组收缩压、舒张压、TG、HDL-C、糖化血红蛋白(HbA1c)比较,差异有统计学意义(P<0.05)。高血压组和糖尿病组ABI高于合并组(1.12±0.09和1.11±0.07 vs 0.93±0.11,P=0.012)。校正高血压、糖尿病病史、年龄、性别、体质量指数、TG、TC、HDL-C、LDL-C、HbA1c、收缩压、舒张压等的影响因素后,ABI与血尿酸呈负相关(r=-0.235,P=0.012)。结论心血管高危患者的ABI与血尿酸可能存在相关性。     

Association between serum uric acid levels and achievement of target blood pressure among Japanese community residents with hypertension

The authors examined the sex-specific association between serum uric acid (SUA) levels and achievement of target blood pressure among Japanese patients with hypertension. This cross-sectional study was conducted between January 2012 and December 2015 and examined 17 113 eligible participants (6499 men; 10 614 women) with hypertension among 66 874 Japanese community residents who underwent voluntary health checkups. Multivariate analysis was used to estimate the association between high SUA level (≥7.0 mg/dL for men and ≥6.0 mg/dL for women) and “therapeutic failure” in achieving target blood pressure (BP) of 140/90 and 130/80 mmHg in both sexes. Multivariate analysis revealed that high SUA level was significantly associated with failure to achieve the 130/80 mmHg treatment goal among men (AOR = 1.24, 95% CI = 1.03–1.50, p = .03). Among women, high SUA level was significantly associated with failure to achieve both the 130/80 and 140/90 mmHg treatment goals (AOR = 1.33, 95% CI = 1.20–1.47, p < .01 and AOR = 1.17, 95% CI = 1.04–1.32, p < .01, respectively). Each increase in SUA quartile was positively associated with increases in systolic BP (SBP) and diastolic BP (DBP) (p < .01 for trend) in both sexes. SBP and DBP in each quartile (Q2–Q4) were also significantly higher compared with those of Q1 in both sexes (p < .01). Our data confirms the difficulties in maintain goal BP control in those with elevated SUA.     

老年高血压患者颈动脉粥样硬化与血尿酸及相关炎症因子的关系

目的分析老年原发性高血压患者的颈动脉粥样硬化(CAS)与血尿酸(SUA)及相关炎症因子的关系。方法选取老年原发性高血压患者42例及血压正常者38例,应用高频多普勒超声检测颈动脉内膜-中层厚度(IMT)及斑块情况,测定血清三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、SUA、超敏C反应蛋白(Hs-CRP)、白介素6(IL-6)和肿瘤坏死因子-α(TNF-α)。结果老年高血压组的SUA、TNF-α、IL-6、Hs-CRP、颈动脉IMT及CAS的发生率明显高于对照组,差异有统计学意义(P<0.05);颈动脉IMT与收缩压(SBP)、SUA、Hs-CRP呈正相关。结论老年高血压CAS的发生和发展除了血压增高的影响因素外,体内SUA的增高及相关炎症因子也参与了CAS的病理生理过程。     

老年冠心病患者血尿酸水平与冠状动脉病变程度的相关性

目的探讨老年冠心病患者血尿酸水平与冠状动脉病变范围及狭窄程度的关系。方法选取289例经冠状动脉造影确诊冠心病（管腔狭窄≥50％）的70岁以上老年冠心病患者。采用Gensini积分评价冠状动脉病变严重程度。术前检查血尿酸水平。对比分析患者血尿酸水平与冠状动脉狭窄程度及范围的关系。结果289例患者中单支病变组、双支病变组和多支病变组患者的血尿酸水平差异无统计学意义[（0．358±0．102）w（0．379±0．112）VS（0．366±0．112），P〉O．05]，不同Gensini积分组患者的血尿酸水平差异无统计学意义[（0．360±0．100）坩（0．375±0．119）w（0．369±0．100）w（0．370±0．123），P〉0．05]，尿酸正常组与高尿酸血症组患者的Gensini积分差异无统计学意义[（37．138±24．934）w（41．887±35．294），P〉0．05]。单独分析男性患者和女性患者，单支病变组、双支病变组和多支病变组的血尿酸水平差异均无统计学意义，不同Gensini积分组患者的血尿酸水平差异无统计学意义。结论目前尚缺乏证据证明血尿酸水平可以作为老年冠心病患者冠状动脉病变严重程度的危险因素或预测因子。     

血清尿酸与我国2型糖尿病患者视网膜病变的相关性研究

目的 探讨血清尿酸（SUA）与我国T2DM患者DR的关系. 方法 采用四分位法将T2DM患者SUA水平分为4组,眼底镜诊断有无DR.采用Logistic多元回归分析SUA与DR发病率的关系. 结果 SUA＞ 212 μmol/L后即为DR危险因素.随着SUA升高（212～288、289～335、≥366μmol/L）,影响程度增加,OR（95％CI）值分别为3.85（1.98～6.84）、5.12（2.25～8.10）、5.71（2.99～8.87）. 结论 SUA是DR的危险因素,降低SUA水平应为其治疗的重要环节.     

冠心病血尿酸与冠脉SYNTAX评分的相关性分析

冠心病的形成是多种危险因素共同作用的结果,针对高尿酸血症、低胆红素血症对冠心病的影响仍有争议。国内外已有多项临床研究显示血清高尿酸可以提高冠状动脉(冠脉)事件的发生风险[1]。SYNTAX评分能更充分及全     

血尿酸水平与主动脉夹层的相关性研究

目的探讨血尿酸水平与主动脉夹层的关系。方法病例组为2009—2012年间124例确诊为主动脉夹层患者,对照组为在性别、年龄、高血压史及体重指数等与病例组相匹配的、同期于我院体检者73例。收集患者的相关临床资料及血尿酸指标,进行相关的统计分析。结果主动脉夹层组血尿酸水平较对照组显著增高,分别为（345．8±119．4）mmol／L和（311．1±66．0）mmol／L（P=-0．006）。主动脉夹层组尿酸水平在性别、年龄以及病变的急慢性之间均无显著差异,但吸烟、合并高血压者的尿酸水平显著高于非吸烟、无高血压患者;非马凡综合征诱发的主动脉夹层组患者的血尿酸水平明显高于马凡综合征合并主动脉夹层组患者,分别为（348．0±120．5）mmol／L和（280．1±56．6）mmol／L（P〈0．05）。结论血高尿酸水平与主动脉夹层的发生存在明显的相关性,且是主动脉夹层发生、发展的可能机制之一。     

血尿酸与冠心病的相关分析

目的分析血清尿酸水平是否与冠心病相关。方法经冠状动脉造影确诊的冠心病患者142例和非冠心病患者92例。分别测定血清尿酸及血脂水平,同时记录性别、年龄、吸烟、高血压、糖尿病等相关因素。结果冠心病患者血清尿酸水平显著高于对照组（P<0.01）,相关分析显示血清尿酸水平与冠脉狭窄指数、年龄、高血压、糖尿病、高密度脂蛋白、胆固醇（P<0.05或P<0.01）呈正相关。多因素回归分析显示,血清尿酸与冠心病的发生和冠脉狭窄指数无明显相关。结论高尿酸血症不是冠心病的独立危险因素。     

正常高值血压患者尿酸与C-反应蛋白的相关性研究

目的:研究正常高值血压患者随血压的升高尿酸与C-反应蛋白(CRP)之间的关系,并探讨其临床意义。方法:184例根据血压分成3组,正常高值血压高组(高值高组)[130～139/85～89mmHg(1mmHg=0.133kPa)]65例,正常高值血压低组(高值低组)(120～129/80～84mmHg)59例,正常血压(正常血压组)(<120/<80mmHg)60例,分别检测血尿酸与CRP。结果:高值低组尿酸与CRP明显高于正常组(P<0.05,P<0.01),高值高组尿酸与CRP明显高于高值低组(P<0.05,P<0.01),并且高值低组与高值高组的尿酸与CRP升高具有相关性,高值高组的相关性又明显高于高值低组,正常血压组两者之间无相关性。结论:尿酸与CRP是高血压的危险因素,两者之间的相互作用加重了高血压的发展。     

原发性高血压患者血清胆红素、尿酸及超敏C反应蛋白变化的临床意义

目的探讨原发性高血压（EH）患者血清胆红索、尿酸（UA）及超敏C反应蛋白（hs-CRP）变化的临床意义。方法选择EH患者101例（EH组）、阵发性室上性心动过速患者103例（对照组）,检测其血清胆红素、UA及hs-CRP。结果与对照组比较,EH组血清总胆红素、直接胆红素和间接胆红素明显降低,且随高血压分级升高而逐渐降低（P〈0．05）;血清UA、hs—CRP明显升高,且随高血压分级升高而逐渐升高（P〈0．05）。结论血清胆红素、UA和hs—CRP是反映EH患者代谢异常的重要指标,可用于评估其病情的严重程度。     

血脂正常原发性高血压患者血尿酸水平与颈动脉粥样硬化的关系

目的探讨血脂正常原发性高血压患者血尿酸水平与颈动脉粥样硬化(carotid atherosclerosis,CAS)斑块及硬化程度的关系。方法选择血脂正常的原发性高血压患者288例,行颈动脉彩色多普勒超声检查,测量左右颈动脉内膜中层厚度,根据测量结果分为斑块组(104例)和无斑块组(184例),将患者CAS程度分为0～4级,所有患者测血脂、血尿酸水平。结果斑块组血尿酸浓度明显高于无斑块组(481 μmol/L vs 289μmol/L,P0.05)。斑块组高尿酸血症发生率较无斑块组明显增高(66.2% vs 13.8%,P0.05)。与CAS 3级患者比较,CAS 0级、1级患者血尿酸水平明显下降;与CAS 4级患者比较,CAS 0级、1级、2级患者血尿酸水平明显下降,差异有统计学意义(P0.05)。结论血脂正常的原发性高血压患者中,CAS斑块形成可能与血尿酸水平升高有关,CAS程度愈高,其相关性愈大。     

社区老年人血尿酸水平与颈股脉搏波速度的相关性研究

目的探讨社区老年人血尿酸水平与颈股脉搏波速度(cf-PWV)的相关性。方法入选2012年3月至2016年6月期间在湖南师范大学第二附属医院解放军第163医院体检中心进行体检的湖南片区军队干休所离退休的老年人840例。依据cf-PWV值分为两组:cf-PWV9 m/s组(n=520)和cf-PWV≥9 m/s组(n=320)。分析比较两组的临床资料和实验室检查指标。采用SPSS17.0统计软件进行统计学分析。结果两组患者的空腹血糖(FPG)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、C-反应蛋白(hs-CRP)、胰岛素抵抗指数(HOMA-IR)和血尿酸间差异均具有统计学意义(P0.05)。剔除年龄、性别、BMI、HOMA-IR等干扰因素,cf-PWV与SBP(r=0.351,P=0.017)、hs-CRP(r=0.250,P=0.033)和血尿酸水平(r=0.647,P=0.000)均呈显著正相关。结论血尿酸是cf-PWV的独立危险因素,可间接反映动脉僵硬度的进展。     

Lack of association between serum uric acid and organ damage in a never-treated essential hypertensive population at low prevalence of hyperuricemia

BACKGROUND: It is still undefined whether serum uric acid (SUA) is an independent risk factor for target organ damage (TOD) and cardiovascular events in human hypertension. We sought to investigate the association of SUA with subclinical cardiac, vascular, and renal alterations in never-treated uncomplicated essential hypertensives. METHODS: A total of 580 subjects with recently diagnosed (<1 year) grade 1 and 2 hypertension, categorized by sex and tertiles of SUA levels, were considered for this analysis. All subjects underwent extensive clinical, laboratory, and ultrasonographic investigations searching for cardiac and extracardiac TOD. RESULTS: Hyperuricemia (SUA >7.0 mg/dL in men and >6 mg/dL in women) was present in 8.3% of the patients. The overall prevalence of left-ventricular hypertrophy (LVH), carotid alterations, and microalbuminuria was 28%, 27%, and 8%, respectively. No differences in the prevalence rates of these TOD markers were present across all SUA tertiles in the entire population, as well as in both sexes. The SUA levels were similar in patients with and without LVH, carotid alterations, or microalbuminuria. When patients were classified according to the number of organs involved, those with multiple TOD (2 or 3 organs) had significantly higher SUA levels (5.1 +/- 1.3 or 5.2 +/- 1.4 mg/dL), as compared with those with a single or no organ involvement (4.9 +/- 1.3 or 4.9 +/- 1.4 mg/dL, P < .05). The association, however, between SUA levels and multiple TOD was not confirmed in a logistic regression analysis. CONCLUSIONS: Our findings do not support the role of SUA as an independent risk factor for subclinical TOD in a selected population of recently diagnosed uncomplicated hypertensives at low prevalence of hyperuricemia.