老年男性高尿酸血症临床特点及相关危险因素分析

目的了解老年男性高尿酸血症患者的临床特点和各种伴随疾病与之的相关性。方法收集2002年至2004年于解放军总医院住院的老年男性高尿酸血症患者和血尿酸正常患者各225例（合并糖尿病各110例），对血尿酸及其影响因素进行横断面回顾性分析。结果高尿酸血症病例占同期住院老年男性患者的10．5％。高尿酸血症组合并肾功能异常远高于血尿酸正常组（27．6％vs6．2％），差异有统计学意义（P=0．0000）。高尿酸血症组年龄、体质量、体质量指数、血压、甘油三酯、总胆固醇、空腹血糖、血肌酐、血尿素、肌酐清除率及高密度脂蛋白胆固醇与血尿酸正常组比较，差异具统计学意义（P〈O．01），冠心病、高血压、高甘油三酯血症、肾功能异常等的患病率均高于血尿酸正常组（P〈0．01）。高尿酸血症组的血尿酸与年龄、体质量、体质量指数、血压、甘油三酯、总胆固醇、糖化血红蛋白、血肌酐、血尿素、肌酐清除率显著相关（P〈0．01）。结论老年高尿酸血症患病率高，以痛风发生为临床特征者不到10％，合并肾脏功能异常者是血尿酸正常组的4．5倍，且常伴随肥胖、糖、脂代谢紊乱和高血压，也是高血压、冠心病、糖尿病、高脂血症以及其他心、脑血管疾病的危险因素。对高尿酸血症患者应加以重视，尽早检出，综合评估心血管危险因素，及时治疗。

Clinical features and influential factors in elderly male patients with hyperuricemia

Objective To determine the clinical features of hyperuricemia and the association between hyperuricemia and accompanied disease in elderly male patients. Methods Elderly male hospitalized patients from 2002 to 2004 in Chinese PLA General hospital were retrospectively analyzed, including 225 patients with hyperuricemia and 225 without, and 110 patients accompanied with diabetes in each group. Demographic information and biochemical examination results were collected and the influential factors of hyperuricemia were analyzed. Results The 10.5% eldely male hospitalized patients presented with hyperuricemia. Significantly more patients were complicated with renal dysfunction in hyperuricemic group than in non-hyperuricemic group （27.6% vs 6.2%, 23 = 36.47, P = 0.0000）. The age, body mass, body mass index, blood pressure, triglyceride, total cholesterol, fasting glucose, blood creatinine, blood urea, creatinine clearance rate and high density lipoprotein cholesterol of hyperuricemic group were also significantly different with non-hyperuricemic group（P 〈 0.01）. In hyperuricemic group, the morbidity rate of coronary heart disease, hypertension, hypertriglyceridemia, renal dysfunction was higher than those in non-hyperuricemic group（P 〈 0.01）. In hyperuricemic group, the serum uric acid level was significantly associated with age, body mass, body mass index, blood pressure, triglyceride, total cholesterol, HbAlc, blood creatinine, blood urea and creatinine clearance rate （P 〈 0.01）. Conclusions The prevalence of hyperu~icemia was high in old male person. Less than 10% hyperuricemia patients had gout, but more （4.5 times） hyperuricemia patients complicated with renal dysfunction than those without hyperuricemia. Hyperuricemia often accompanied with obesity, glucose and lipid metabolic dysfunction and hypertension. Hyperuricemia may be a risk factor of hypertension, coronary heart disease, diabetes and hyperlipidemia. We should pay more attention to the patient with hyperuricemia, and try to diagnose and treat the disorder as early as possible.