随访老年高血压患者血尿酸与血脂变化的关系

张海琳; 林帆; 黄峰; 朱鹏立

doi:10.13201/j.issn.1001-1439.2018.09.012

随访老年高血压患者血尿酸与血脂变化的关系

- 1 福建医科大学附属第一医院心血管内科(福州, 350005);
- 2 福建医科大学省立临床医学院老年科
基金项目:
福建省卫生系统中青年骨干人才培养项目 (No:2013-ZQN-ZD-4)

详细信息

通讯作者: 朱鹏立,E-mail:zpl7755@126.com

中图分类号: R544.1

收稿日期: 2018-06-18

Relationship between serum uric acid level and blood lipid after follow-up in hypertensive patients

- 1 Cardiovascular Department, the First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, China;
- 2 Geriatric Department, Provincial Clinical College of Fujian Medical University

More Information

Corresponding author: ZHU Pengli, E-mail: zpl7755@126.com

Received Date: 18 June 2018

摘要

摘要: 目的:随访3.6年观察前后老年高血压患者血尿酸变化与血脂变化的关系, 探讨血尿酸变化对药物调脂治疗的影响。方法:入选2007-08-2009-09在福建省立医院住院治疗的1 648例高血压病患者中, 随访3年后再入院的883例, 收集患者基线及随访资料。结果:883例患者的再入院时间平均为3.6年。与基线资料比较, 随访3.6年后血尿酸水平升高[(355.08±102.66) μmol/L:(363.69±118.83) μmol/L, P＜0.05], 三酰甘油[(1.67±1.18) mmol/L:(1.52±0.94) mmol/L]、总胆固醇[(4.90±2.27) mmol/L:(4.56±1.26) mmol/L]、高密度脂蛋白胆固醇 (HDL-C)[(1.20±0.38) mmol/L:(1.17±0.39) mmol/L]、非高密度脂蛋白胆固醇 (nonHDL-C)[(3.69±2.25) mmol/L:(3.39±1.18) mmol/L]降低 (均P ≤ 0.01)。与随访期间尿酸升高的患者比较, 尿酸下降患者的三酰甘油[235 (51.20%):267 (63.57%)]、总胆固醇[241 (52.51%):252 (60.00%)]、低密度脂蛋白胆固醇 (LDL-C)[213 (46.41%):226 (53.81%)]、non-HDL-C[213 (46.41%):226 (53.81%)]下降的比例较高。逐步多元线性回归以血脂变化为因变量, 以血尿酸变化、年龄增长、体质指数 (BMI) 变化、血压变化、降压药物强度积分变化及是否接受调脂治疗等为自变量, 显示血尿酸变化与三酰甘油变化、总胆固醇变化、LDLC变化、non-HDL-C变化 (β值=0.114×10^-2、0.103×10^-2、0.102×10^-2、0.119×10^-2, 均P＜0.05) 存在独立线性关系。结论:随访期间血尿酸水平下降的患者血脂水平控制得更好, 提示适当控制老年高血压患者的血尿酸水平可能有助于血脂控制。
- 高血压 /
- 尿酸 /
- 血脂
Abstract: Objective: To investigate the relationship between the changes of serum uric acid and blood lipid in elderly patients with hypertension during 3.6 years of follow-up, to observe the effect of serum uric acid changes on the treatment effects of lipid-lowering drugs.Method: A retrospective study way was performed in the subjects included 883 cases who had a readmission after 3 years of follow up in an original cohort of 1 648 patients with diagnosis of essential hypertension in Fujian Provincial Hospital from August 2007 to September 2009, and the hospitalized information of baseline and follow-up were collected.Result: The average readmission period was 3.6 years.Compared with baseline values, serum uric acid levels[(355.08±102.66) μmol/L vs (363.69±118.83) μmol/L, P＜0.05]increased and triglyceride[(1.67±1.18) mmol/L vs (1.52±0.94) mmol/L], total cholesterol[(4.90±2.27) mmol/L vs (4.56±1.26) mmol/L], high density lipoprotein cholesterol (HDL-C)[(1.20±0.38) mmol/L vs (1.17±0.39) mmol/L], non high density lipoprotein cholesterol (non-HDL-C)[(3.69±2.25) mmol/L vs (3.39±1.18) mmol/L, all P ≤ 0.01]decreased after 3.6 years.The rate of decline on triglyceride[235 (51.20%) vs 267 (63.57%)], total cholesterol[241 (52.51%) vs 252 (60.00%)], low density lipoprotein cholesterol (LDL-C)[213 (46.41%) vs 226 (53.81%)]and non-HDL-C[213 (46.41%) vs 226 (53.81%), all P＜0.05]was higher in patients with decreased uric acid than patients with increased uric acid 3.6 years later.Stepwise multiple linear regression analysis showed that changes in serum uric acid and changes in triglyceride, cholesterol, LDL-C, non-HDLC (β=0.114×10^-2, 0.103×10^-2, 0.102×10^-2, 0.119×10^-2;all P＜0.05) had independent linear relationships while changes of lipid was the dependent variable and changes of serum uric acid, age, body mass index, blood pressure, anti-hypertensive therapeutic intensity scores and lipid-lowering drug was independent variables etc.Conclusion: Patients with lower serum uric acid levels during the follow-up period had better control of blood lipid levels, suggesting that appropriate control of serum uric acid levels may help control blood lipid.
- hypertension /
- uric acid /
- blood lipid

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