维持性血液透析患者尿酸、C反应蛋白水平与心脑血管疾病的关系

目的：探讨维持性血液透析患者（MHD）血清尿酸（UA）及C反应蛋白（CRP）与心血管疾病的关系。方法：选择MHD患者48例，记录这些患者的心血管疾病病史、性别、年龄、血压、身高、体质量，透析前采血查血清UA、CRP、白蛋白、血红蛋白、尿素、血清总胆固醇、低密度脂蛋白、Lp（α）等。随诊1年，评价血清uA及CRP水平与心血管疾病及死亡的关系。结果：48例患者中有心脑血管疾病患者29例，无心脑血管疾病患者19例，心脑血管疾病组的UA及CRP明显高于无心脑血管疾病组（P＜0．01）。48例患者入组时血清UA水平为（504．4±156．4）μmol·L，其中高尿酸血症26例（54．17％）；CRP升高者27例（56．25％）。高尿酸血症伴CRP升高者16例（33．33％）。高尿酸血症伴CRP升高组的心脑血管疾病发生率及死亡率明显高于其他组（P〈0．01）。死因多为心力衰竭及脑出血。结论：高尿酸血症与CRP共同作用可增加维持性血液透析患者的心脑血管疾病发生率及病死率。

Serum Uric Acid and C-reactive Protein Correlate with Cardiovascular Disease in Maintenance Hemodialysis Patients

Objective：To identlify the relationship the serum lelvel of uric acid （UA） and C-reactive protein（CRP） and their cooperation in cardiovascular disease in maintenance hemodialysis （MHD） patients. Methods：The study included 48 MHD patients who were followed-up for more than one year in our dialysis center. Histories of cardiovascular disease, sex, age, blood pressure, height, body weight were recorded. Serum were sampled for the determination of UA,CRP,albumin, urea, Hb, total cholesterol,low-density lipoprotein, Lp（α） assay. UA and CRP correlation with cardiovascular disease were evaluated. Results：Twentynine patients had cardiovascular disease（myocardial infarction,angina pectoris and chronic heart failure）. Patients with cardiovascular disease had significantly higher UA and CRP（P〈0. 01） than patients without cardiovascular disease. All of 48 patients have hyperuricemia 26 （54. 17 % ）, elevated CRP 27 （56.25%） and hyperuricemia with elevated CRP 16（33.33 % ）. Patients in hyperuricemia with elevated CRP group had higher incidence of cardiovascular disease and higher mortality rate as compared with patients in others group. The prominent causes death were heart failure and cerebral hemorrhage. Conchtsion： The cooperation of hyperuricemia and elevated CRP could increase the incidence of cardiovascular disease and higher mortality rate in maintenance hemodialysis patients.