随访原发性高血压患者血尿酸变化与左心室结构功能改变的关系(1)
[摘要] 目的 分析原发性高血压患者血尿酸变化与左室结构功能改变的关系。 方法 方便选取2007年8月—2009年9月在福建省立医院住院并于3年后再次入院的原发性高血压患者357例，收集血尿酸、心脏彩超等指标。 结果 随着血尿酸水平升高，室间隔厚度(IVST)、左心室后壁厚度(LVPWT)、左心室舒张末期内径(LVDd)、左心室质量(LVM)、左心室质量指数(LVMI)逐渐增加。多元线性回归调整年龄、性别、降压药物强度积分、血压等，显示血尿酸与LVMI呈线性正相关关系(β=5.476×10-2，P<0.001)。根据3年后血尿酸变化分为N-N组、N-H组、H-N组和H-H组，多元Logistic回归调整增龄、降压药物强度积分变化、舒张压变化等，显示与N-N组相比，N-H组、H-N组和H-H組发生左心室肥厚的OR值分别为4.897、3.696和5.712(P<0.05)。 结论 血尿酸变化与左心室结构改变独立相关，血尿酸水平升高增加原发性高血压患者左心室肥厚发生的风险。
[关键词] 高血压；尿酸；左心室肥厚
[中图分类号] R544.1 [文献标识码] A [文章编号] 1674-0742(2018)11(b)-0010-04
Follow-up of Correlation between the Changes of Blood Uric Acid and Structural and Functional Changes of Left Ventricle of Hypertension Patients
ZHANG Hai-lin
Department of Cardiovascular Medicine， First Affiliated Hospital of Fujian Medical University， Fuzhou， Fujian Province， 350005 China
[Abstract] Objective To analyze the correlation between the changes of blood uric acid and structural and functional changes of left ventricle of hypertension patients. Methods 357 cases of patients with primary hypertension admitted and treated in our hospital from August 2007 to September 2009 were convenient selected， and the blood uric acid and heart color ultrasound were collected. Results With the increase of the blood uric acid level， the IVST， LVPWT， LVDd， LVM， LVMI gradually increased， and the age， gender， intensity score of antihypertensive drugs and blood pressure were adjusted by the multiple linear regression， showing the blood uric acid was positively correlated with the LVMI(β=5.476×10-2， P<0.001) ， and the patients were divided into the N-N group， N-H group， H-N group and H-H group according to the changes of blood uric acid after three years， and the aging， changes of intensity score of antihypertensive drugs and changes of diastolic pressure were adjusted by the multi-Logistic regression， showing the OR values of left ventricular hypertrophy were respectively 4.897， 3.696， 5.712 in the N-H group， H-N group and H-H group compared with that in the N-N group(P<0.05). Conclusion The changes of blood uric acid is correlated with the changes of changes of left ventricle， and the increase of blood uric acid level can increase the occurrence risk of left ventricular hypertrophy of primary hypertension patients.
[Key words]Hypertension； Uric acid； Left ventricular hypertrophy
尿酸是人类嘌呤核苷酸代谢的内源性终产物，人体无法将尿酸转化为可溶性的尿囊素，因此血尿酸水平高于其他大多数编码尿酸酶的哺乳类动物[1]。随着国民生活改善以及膳食结构的改变，我国高尿酸血症患病率逐年上升，其流行病学趋势与高血压、动脉硬化、心力衰竭、慢性肾脏病(chronic kidney disease，CKD)、糖尿病、代谢综合征等相似，是心脑血管疾病重要的危险因素，受到广泛关注。有研究表明，血尿酸水平与冠心病患者心肌重构及心脏功能具有显著相关性[2]，但关于血尿酸改变与心脏结构功能变化的研究较少，因此，该研究方便选取2007年8月—2009年9月在福建省立医院住院的357例原发性高血压患者，随访3年后血尿酸和心脏彩超改变，旨在分析原发性高血压患者血尿酸变化与左心室结构功能改变的关系，进一步探讨高尿酸血症对心脏结构和功能的影响。, 百拇医药(张海琳)
[关键词] 高血压；尿酸；左心室肥厚
[中图分类号] R544.1 [文献标识码] A [文章编号] 1674-0742(2018)11(b)-0010-04
Follow-up of Correlation between the Changes of Blood Uric Acid and Structural and Functional Changes of Left Ventricle of Hypertension Patients
ZHANG Hai-lin
Department of Cardiovascular Medicine， First Affiliated Hospital of Fujian Medical University， Fuzhou， Fujian Province， 350005 China
[Abstract] Objective To analyze the correlation between the changes of blood uric acid and structural and functional changes of left ventricle of hypertension patients. Methods 357 cases of patients with primary hypertension admitted and treated in our hospital from August 2007 to September 2009 were convenient selected， and the blood uric acid and heart color ultrasound were collected. Results With the increase of the blood uric acid level， the IVST， LVPWT， LVDd， LVM， LVMI gradually increased， and the age， gender， intensity score of antihypertensive drugs and blood pressure were adjusted by the multiple linear regression， showing the blood uric acid was positively correlated with the LVMI(β=5.476×10-2， P<0.001) ， and the patients were divided into the N-N group， N-H group， H-N group and H-H group according to the changes of blood uric acid after three years， and the aging， changes of intensity score of antihypertensive drugs and changes of diastolic pressure were adjusted by the multi-Logistic regression， showing the OR values of left ventricular hypertrophy were respectively 4.897， 3.696， 5.712 in the N-H group， H-N group and H-H group compared with that in the N-N group(P<0.05). Conclusion The changes of blood uric acid is correlated with the changes of changes of left ventricle， and the increase of blood uric acid level can increase the occurrence risk of left ventricular hypertrophy of primary hypertension patients.
[Key words]Hypertension； Uric acid； Left ventricular hypertrophy
尿酸是人类嘌呤核苷酸代谢的内源性终产物，人体无法将尿酸转化为可溶性的尿囊素，因此血尿酸水平高于其他大多数编码尿酸酶的哺乳类动物[1]。随着国民生活改善以及膳食结构的改变，我国高尿酸血症患病率逐年上升，其流行病学趋势与高血压、动脉硬化、心力衰竭、慢性肾脏病(chronic kidney disease，CKD)、糖尿病、代谢综合征等相似，是心脑血管疾病重要的危险因素，受到广泛关注。有研究表明，血尿酸水平与冠心病患者心肌重构及心脏功能具有显著相关性[2]，但关于血尿酸改变与心脏结构功能变化的研究较少，因此，该研究方便选取2007年8月—2009年9月在福建省立医院住院的357例原发性高血压患者，随访3年后血尿酸和心脏彩超改变，旨在分析原发性高血压患者血尿酸变化与左心室结构功能改变的关系，进一步探讨高尿酸血症对心脏结构和功能的影响。, 百拇医药(张海琳)