男性高尿酸血症患者血尿酸与PAI-1和内皮素的关系

目的：探讨中老年男性高尿酸血症患者血浆纤溶酶原激活物抑制剂-1（PAI-1）与内皮素（ET）水平变化，观察高尿酸对血管内皮细胞功能的影响。方法：随机选择35岁以上的男性高尿酸血症患者138例（高尿酸血症，UA组），年龄、地域相匹配的健康者80例为正常对照组。采用酶联免疫吸附双抗体夹心法测定PAI-1，采用放射免疫法测定ET。胰岛素抵抗指数采用稳态模型评估（HOMA—IR）。采用尿酸氧化酶法测定血尿酸。结果：（1）UA组PAI-1、ET水平高于正常对照（均P〈0．01）。（2）UA组收缩压、舒张压、腰围与臀围比值、体质量指数与正常对照组相比差异有统计学意义（P〈0．05或P〈0．01）。（3）uA组胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-c）、空腹血糖、糖负荷后2h血糖、空腹胰岛素、HOMA—IR均显著高于正常对照组（P〈0．05或P〈0．01）。（4）UA组高密度脂蛋白胆固醇（HDL-c）低于正常对照组（P〈0．05）。（5）在以PAI-1为因变量的逐步回归分析中血尿酸、腰围与臀围比值、HOMA—IR进入回归方程（调整后R2=0．77，P〈0．01）。（6）在以ET为因变量的逐步回归分析中，血尿酸、血肌酐、腰围与臀围比值、HOMA—IR进入回归方程（调整后R2=0．70，P〈0．01）。结论：高尿酸是血管内皮细胞功能障碍独立的危险因素，降低血尿酸水平有望改善血管内皮细胞功能，减少动脉粥样硬化的发生和发展。

Studied the Relationship between the Serum Uric Acid and Plasminogen Activator Inhibitor 1 or Endothelin in Middle and Aged Male Patients with Hyperuricemia

Objective: To study the variation of plasminogen activator inhabitor-1 (PAI-1) and endothelin (ET) in middle and old age male patients with hyperuricemia, and investigate the effect on vascular endothelial function by hyperuricemia. Methods: One hundred and thirty eight male patients who were over 35 years old with hyperuricemia were randomly into two groups: the hyperuricemia group (UA Group), and then served 80 healthy persons with the same age area as the control group. Blood plasm PAI-1 levels were measured by enzyme-linked immunosorbent assay (ELISA) and ET was examired by radioimmunoassay. Insulin resistance was applied by homeostasis model assessment of insulin resistance (HOMA-IR). Serum uric acid levels were determined according to an uricase method. Results: (1)PAI-1 and ET of the UA group were notably higher than those of the control group (P < 0.01). (2)Systolic blood pressure, diastolic blood pressure, the ratio of waist girth to hip girth, body mass index (BMI) in the UA group and the control group had difference that was statistical (P < 0.05 or P < 0.01). (3)Fasting blood glucose, charging blood glucose at two hours, fasting insulin, HOMA-IR, total cholesterol (TC), triglycerides (TG), low density lipoprotein (LDL-c) in the UA group were significantly higher than those of control group (P < 0.05 or P < 0.01). (4)High density lipoprotein (HDL-c) in the UA group was lower than that of the control group (P < 0.05).(5)Multivariate stepwise regression analysis revealed that serum uric acid, the ratios of waist girth to hip girth and HOMA-IR contributed to PAI-1 equation (adjusted R2=0.77, P < 0.01). (6)Serum uric acid, creatinine, the ratios of waist girth to hip girth and HOMA-IR entered the equation of ET (adjusted R2=0.70, P < 0.01). Conclusion: Hyperuricemia is one of the independent risk factors of vascular endothelial cells functional disorder. Vascular endothelial cell function will be improved by reducing the serum uric acid level, and hence decreased atherosclerosis occurrence and development.