成人患者血尿酸水平调查及相关影响因素分析

doi:10.16138/j.1673-6087.2023.03.002

摘要/Abstract

摘要：

目的: 调查分析成人患者血尿酸测定值的分布特点及相关影响因素，为高尿酸血症（hyperuricemia，HUA）防治提供依据。方法: 对上海交通大学医学院附属瑞金医院2018年6月共47 100例18岁以上检测人群的血尿酸进行回顾性分析，其中男性27 091例，女性20 009例。研究不同性别、部门、年龄段的血尿酸数值及分布情况。结果: HUA总检出率20.26%，其中男性检出率22.82%，女性检出率16.88%。男性、50岁及以下女性血尿酸水平与年龄呈负相关（均P<0.05）；50岁以上女性血尿酸水平与年龄呈正相关（P<0.05）。HUA最高发年龄段男性为18~30岁，女性为71岁以上（均P<0.05），高发部门前3位依次为肾脏病区、门诊心外科、门诊高血压。结论: HUA检出率较高，男性总体血尿酸水平高于女性，男性血尿酸水平随年龄增长逐渐下降，女性血尿酸水平呈先降后升趋势。根据上述HUA数据分布特点，可针对易感人群加强宣教及防治工作。

关键词: 慢性肾脏病, 血尿酸检测, 高尿酸血症

Abstract:

Objective To investigate the distribution characteristics of hyperuricemia(HUA) and related influencing factors among the adult patients in Ruijin Hospital, and provide the clinical reference for prevention and treatment of HUA. Methods A retrospective study of serum uric acid was carried out on 47 100 people in Ruijin Hospital in June 2018, who were over 18 years old. Among them, 27 091 were males and 20 009 were females. The value of serum uric acid and distribution in different gender, age groups and clinical departments were studied. Results The total detection rate of HUA was 20.26%; it was 22.82% in male, and it was 16.88% in females. The serum uric acid level was negatively correlated with age in males, and females (≤50 years) (P<0.05), while it was positively correlated with female over 50 years (P<0.05). The high incidence age groups were 18-30 years in male, and in women over 71 years(P<0.05). Three departments with the highest HUA detection rate were the departments of nephrology, cardiac surgery outpatient and hypertension outpatient. Conclusions The detection rate of HUA in the study was high. The overall blood uric acid level in men was higher than that in women. The blood uric acid level in men gradually decreased with age, and the blood uric acid level in women showed a trend of decreasing and then increasing. Learning the distribution characteristics of uric acid in population could give help in strengthening education and prevention work in the susceptible population.

Key words: Chronic kidney disease, Uric acid detection, Hyperuricemia

中图分类号:

R692

罗亚丹, 袁立英, 陆怡德, 王子秋, 王朝晖. 成人患者血尿酸水平调查及相关影响因素分析[J]. 内科理论与实践, 2023, 18(03): 141-145.

LUO Yadan, YUAN Liying, LU Yide, WANG Ziqiu, WANG Zhaohui. Investigation of serum uric acid level in adult patients and analysis of related influencing factors[J]. Journal of Internal Medicine Concepts & Practice, 2023, 18(03): 141-145.

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参考文献 18

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组别	男性	女性	χ²	P
18~30岁	29.21（772/2 643）	13.95（310/2 223）	162.695	<0.001
31~40岁	28.47（1 158/4 067）	13.99（390/3 003）	242.250	<0.001
41~50岁	26.29（981/3 732）	10.88（338/3 107）	258.557	<0.001
51~60岁	19.94（1 088/5 457）	15.48（622/4 017）	31.025	<0.001
61~70岁	19.22（1 267/6 593）	19.56（935/4 780）	0.209	0.647
71岁以上	19.57（900/4 599）	27.20（783/2 879）	59.063	<0.001
合计	22.76（6 166/27 091）	16.88（3 378/20 009）	246.099	<0.001

组别	总体水平	男性		女性
组别	总体水平	n	血尿酸	n	血尿酸
18~30岁	334.21±103.40	2 643	376.98±93.69	2 223	283.36±90.60
31~40岁	331.62±105.67	4 067	375.38±100.79	3 003	272.36±80.18^1）
41~50岁	320.27±103.63^1）2）	3 732	363.49±99.76^1）2）	3 107	268.35±82.14^1）
51~60岁	313.86±111.56^1）2）3）	5 457	336.45±119.01^1）2）3）	4 017	283.17±92.07^2）3）
61~70岁	315.51±110.33^1）2）3）	6 593	336.04±113.92^1）2）3）	4 780	287.18±98.41^2）3）4）
71岁以上	322.61±119.99^{1）2）4）5）}	4 599	329.92±120.53^{1）2）3）4）5）}	2 879	310.94±118.21^{1）2）3）4）5）}

血尿酸分级（μmol/L）	n	男性	女性	χ²	P
0~179	3 811	1 794（6.62）	2 017（10.08）	185.092 9	<.0001
180~300	17 075	6 627（24.46）	10 448（52.22）	3 836.140 8	<.0001
301~359	10 483	6 356（23.46）	4 127（20.63）	53.493 3	<.0001
360~419	8 006	6 064（22.38）	1 942（9.71）	1 311.172 4	<.0001
420~479	4 380	3 549（13.10）	831（4.15）	1 092.286 2	<.0001
480~539	1 948	1 607（5.93）	341（1.70）	518.798 3	<.0001
540以上	1 397	1 094（4.04）	303（1.51）	254.731 3	<.0001
合计	47 100	27 091（100.00）	20 009（100.00）	/	/

部门	n	血尿酸阳性 [n（%）]	HUA阳性者血尿酸水平（μmol/L ）
肾脏病区	401	184（45.89）	498.02±109.76
门诊心外科	82	37（45.12）	477.57±66.52
门诊高血压	809	290（35.85）	461.22±62.52
门急诊泌外科	990	340（34.34）	468.53±79.63
产休病区	132	44（33.33）	505.02±131.54
门诊肾脏内科	3 432	1 129（32.90）	465.95±70.53
门诊肝移植	37	12（32.43）	492.54±82.15
预防保健科	111	34（30.63）	485.54±85.78
高血压病区	113	33（29.20）	488.53±81.87
门诊核医学	100	29（29.00）	464.93±79.49