高尿酸血症患者血浆超敏C反应蛋白和血脂水平分析

目的分析高尿酸血症（HUA）患者血浆超敏C反应蛋白（hs—CRP）和血脂水平特征，并探讨其临床意义。方法收集川北医学院附属医院2012年1月~2013年6月体检中心筛查出的高尿酸血症患者（hyperuricemia，HUA）72例和健康体检者30例，检测其血浆hs—CRP、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（LL-C）、载脂蛋白A（ApoA）、载脂蛋白B（ApoB）、脂蛋白（a）ELp（a）]和同型半胱氨酸（HCY）浓度，并进行统计学分析。结果HUA患者血浆中hs-CRP，TG，VLDL-C和HCY浓度较对照组显著增高（t=2．81～4．11，P值均〈0．01），而HDL=C和ApoA浓度较对照组显著降低（t=3．10，P〈O．01；t=2．11，P〈O．05）；HUA患者以TG和VLDL-C的升高最为明显，其阳性率分别为58．3％和65．3％，并主要表现为Ⅳ型高脂蛋白血症。HUA患者的血尿酸水平与血浆hs-CRP，TG，ApoB，VLDL-C和HCY浓度均呈明显的正相关，而与HDL—C，ApoA浓度呈明显的负相关（r=0．29～0．43，P〈0．05）。结论HUA患者存在血浆hs—CRP水平升高和血脂代谢紊乱，并且主要表现为Ⅳ型高脂蛋白血症。长期的炎症反应和血脂代谢素乱可能是HUA患者易罹患心血管疾病的原因。

Analysis of High-sensitivity C-reactive Protein,and Plasma Lipids Levels in Patients with Hyperuricemia

Objective To investigate plasma levels of high-sensitivity C-reactive protein（hs-CRP） and lipids in patients with hyperuricemia,and to analyse its clinical significance. Methods A total of 72 patients with hyperuricemia and 30 healthy controls in Affiliated Hospital of North Sichuan Medical College from January 2012 to June 2013 were enrolled in this study. Levels of hs-CRP,triglyceride （TG）,total cholestrol （TC）, high density lipoprotein cholestrol （HDL-C）,low density lipo- protein cholestrol （LDL-C）,apolipoprotein A （ApoA）, apolipoprotein B （ApoB）, lipoprotein （a） I-Lp（a）~ and homocysteine （HCY） were measured in both groups. Then the relationships between uric acid, hs-CRP, HCY and lipids level were also ex- plored. Results The plasma levels of hs-CRP, TG, VLDL-C and HCY in patients with hyperuricemia were significantly higher than control group （t = 2.81~4. 11, P~0.01）, and the levels of H DL-C and ApoA was significant lower than control group （t = 3.10, P~0.01 ~ t = 2.11, P~0.05）. In patients with hyperuricemia, the level of plasma uric acid were positively correlated with hs-CRP,TG, ApoB,VLDL-C and HCY, and were negatively correlated with HDL-C and ApoA（r= 0. 29 0. 43,P~0. 05）. Conclusion The patients with hyperuricemia had increased hs-CRP level and disorder of lipid metabolism, and had a clinical expression of type IV hyperlipoproteinemia. These alterations may be susceptible to the cause of cardiovas- cular disease in patients with hyperuricemia.