【摘要】 目的 研究慢性肾脏病(CKD)患者肾损害不同阶段血尿酸(uric acid,UA)水平的变化及其与心血管疾病的关系。方法 对189例非透析治疗的CKD患者的临床及实验室资料作回顾性研究，分析肾损害不同阶段血UA与其他相关因素特别是与心血管事件的关系。结果 CKD患者肾损害不同阶段均存在高尿酸血症(hyperuricemia)，其血UA水平均较对照组呈显著性升高(均P<0.05)。血UA水平与超声心动图异常、心电图异常及心血管事件的发生(P<0.01)、收缩压及舒张压(P<0.05)、血总胆固醇(T-Ch)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)浓度及血肌酐呈正相关(P<0.05)；而与血高密度脂蛋白胆固醇(HDL-C)浓度呈负相关(P<0.05)。结论 CKD患者普遍存在尿酸代谢的异常，血UA水平的升高与心血管事件的发生呈正相关。血UA升高的原因部分可能与其代谢受肾功能的影响有关，可能是CKD患者并发心血管事件的危险因素之一。

    【关键词】 慢性肾脏病；血尿酸；心血管疾病

    Changes of uric acid in patients with chronic kidney disease and its relationship with cardiovascular disease

    WU Bi-bo,ZHANG Li-ming,HAO Xiao-ping.

    Kidney Division,Shanghai Changzheng Hospital Zhabei Branch,Shanghai 200070,China

    【Abstract】 Objective To investigate the changes of uric acid in patients with chronic kidney disease (CKD) treated by non-dialysis and analyze its relation to cardiovascular events.Methods Clinical data and laboratory data of 189 non-dialysis patients was collected and analyzed.Relationship between uric acid and complications was studied.Results The average serum level of uric acid was significantly higher in CKD patients than that in the control group (both P<0.05).The serum level of uric acid was positively correlated with systolic pressure and diastolic pressure (both P<0.05),with the serum level of creatinine and with T-ch and TG and LDL-C level of serum (both P<0.05).A positive correlation of the serum level of uric acid was also found with clinical manifestations such as abnormal echocardiography,ECG and cardiovascular events.A negative correlation was discovered between the serum level of uric acid and the serum level of HDL-C (P<0.05).Conclusion The markedly elevated level of uric acid in CKD patients indicates that the renal function may have the effect on the metabolism of uric acid.Hyperuricemia may be a risk factor of cardiovascular disease. ......