摘要
目的:比较原发性醛固酮增多症(PA)和原发性高血压(EH)患者血尿酸水平的差异,探讨血尿酸水平与肾脏早期损害的关系。方法:选择因"高血压查因"住院确诊的资料完整的病例,按性别、年龄、高血压水平及其病程等匹配原则纳入117例PA患者和117例EH患者,比较两组患者血脂、血糖、血尿酸等代谢紊乱程度和肾靶器官损害的差异。结果:(1)PA患者尿酸水平显著低于EH患者[(314.00±89.52)μmol/L vs(379.16±101.25)μmol/L,P<0.01],但其尿微量白蛋白排泄率(UAER)显著高于EH患者[18.65(9.58,35.99)μg/min vs 9.00(4.53,18.70)μg/min,P<0.01],两组患者e GFR、肌酐、尿素氮水平无显著差异(P>0.05)。(2)高尿酸血症的PA患者与正常尿酸水平的PA患者之间UAER、肌酐、尿素氮、e GFR水平无显著差异(均P>0.05);高尿酸血症的EH患者较正常尿酸水平的EH患者UAER、肌酐、尿素氮升高,而e GFR水平下降(均P<0.05)。(3)多重线性回归分析显示在校正年龄、病程、BMI后,PA患者的卧位醛固酮水平、入院收缩压对其UAER有独立预测价值(P<0.05),但尿酸对UAER无影响(P>0.05);EH患者尿酸及入院收缩压均对其UAER有独立预测价值(P<0.05)。结论 PA患者尿酸水平较EH患者低。PA患者血尿酸水平与其肾脏早期损害无相关性,而EH患者血尿酸水平与肾脏早期损害有关。
Objective：To compare serum uric acid （UA） levels between patients with primary aldosteronism （PA） and essential hypertension （EH）, and to explore its correlation with early renal damage. Methods：A total of 117 cases with PA and 117 controls with EH individually matched 1：1 by sex, age, blood pressure and duration of hypertension were recruited from in-hospital patients who were hospitalized because of suspicion of secondary hypertension. Results： （1） PA patients have significantly lower serum UA level than EH patients [ （314.00±89.52） μmol/L vs. （379.16±101.25） μmol/L,P〈0.01], while they have higher urinary albumin excretion rate （UAER） than EH controls [ 18.65 （9.58,35.99）μg/min vs. 9.00 （4.53, 18.70 ）μg/min,P〈0.01]. There was no significant difference in estimated glomerular filtration rate （eGFR）, serum creatinine （SCr） and blood urea nitrogen （BUN） between PA and EH patients （P〉0.05）. （2） There was no significant difference in eGFR, SCr and BUN between PA patients with hyperuricemia and normouriccmia（P〉0.05）. EH patients with hyperuricemia revealed increased UAER, SCr and BUN and decreased eGFR compared with normouricemic EH patients （P〈0.05）. （3） After adjusting age, duration of hypertension and BMI, multiple linear regression analysis demonstrated that systolic pressure and supine plasma aldosterone concentration （P〈0.05） other than serum UA （P〉0.05） independently predicted UAER in PA patients, while both systolic pressure and serum UA independently predicted UAER in EH patients （P〈0.05）. Conclusion： PA patients have lower serum UA than EH controls, and serum UA was not associated with early renal damage. In EH patients, serum UA independently predicted early renal damage, and hyperuricemia was correlated with the renal dysfunction.
出处
《岭南急诊医学杂志》
2016年第2期138-140,155,共4页
Lingnan Journal of Emergency Medicine
基金
国家自然科学基金(81471011)
广东省自然科学基金(2014A030313081)
