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投稿时间：2018-09-12 网络发布日期：2019-06-21
投稿时间：2018-09-12 网络发布日期：2019-06-21
中文摘要: 目的 探讨老年患者血尿酸(SUA)水平与缺血性脑白质病变(WML)严重程度的关系。方法 采用横断面研究,收集2015年1月至2017年12月于中国人民解放军东部战区空军医院老年医学科住院的328例缺血性WML患者的人口统计学及临床资料,对其进行体格检查,询问病史,抽血查肝功能、肾功能、血糖、血脂、SUA、糖化血红蛋白(HbAlc)、C反应蛋白(CRP),同时行头颅MRI检查,根据年龄相关性脑白质改变视觉评定法(ARWMC)对WML进行影像学分级。分析SUA水平与WML严重程度的相关性。结果 根据有无高尿酸血症将患者分为HUA组（69例）和尿酸正常组（NUA，259例）。高尿酸血症组(HUA)的体重、体质指数(BMI)、SUA、尿素(BUN)、肌酐(Scr)、三酰甘油(TG)、HbAlc及CRP均明显高于尿酸正常组(NUA)(P<0.01),HDL-C显著低于NUA组(P<0.01),高血压、糖代谢异常、脑卒中、超重或肥胖、肾功能不全及颈动脉粥样硬化的发生率高于NUA组(P<0.01)。NUA组WML主要以轻度损害为主(72.59%),而HUA组以中、重度损害为主(分别为:21.74%、33.33%)，随着SUA水平升高,WML损害程度随之加重。Logistic多元回归分析显示,高血压、颈动脉粥样硬化和HUA是老年患者发生WML的独立危险因素(P<0.01)。结论 老年患者SUA水平升高与WML的发生发展密切相关,可认为SUA是老年患者发生缺血性WML的独立危险因素。
中文关键词: 血尿酸 脑白质病变,缺血性 磁共振成像 年龄相关性脑白质改变视觉评定法
Abstract:ObjectiveTo investigate the relationship between serum uric acid (SUA) level and severity of ischemic white matter lesion (WML) in elderly patients. Methods A cross-sectional study was performed on the demographic and clinical data of 328 elderly inpatients with ischemic WML in the Department of Geriatrics in Air Force Hospital of PLA Eastern Theater Command from January 2015 to December 2017.Physical examination,inquiry about medical history,blood sampling for liver function,renal function,blood sugar,blood lipid,SUA,glycosylated hemoglobin(HbAlc),C-reactive protein(CRP),and cranial MRI were performed for all patients.WML in MRI were graded according to age-related white matter change visual assessment (ARWMC).The correlation between SUA level and severity of WML was analyzed. Results The patients were divided into normouricemia (NUA,n=69) group and hyperuricemia (HUA,n=259) group according to the diagnostic criteria of HUA.The levels of weight,body mass index(BMI),SUA,blood urea nitrogen(BUN),serum creatinine (Scr),triglyceride (TG),HbAlc and CRP in HUA group were significantly higher than those in NUA group (all P＜0.01),and high-density lipoproteins cholesterol (HDL-C) level was significantly lower than that in NUA group (P＜0.01).The incidences of hypertention,abnormality of glucose metabolism,stroke,overweight and obesity,kidney insufficiency and carotid atherosclerosis in HUA group were significantly higher than those in NUA (all P＜0.01).In HUA group,21.74% and 33.33% patients presented with moderate and severe white matter damage respectively;while in NUA group,72.59% patients presented with mild damage.The damage degree of WML aggregated with the increase of SUA level.Logistic multiple regression analysis showed that hypertension,carotid atherosclerosis and HUA were the risk factors of WML in elderly patients. Conclusion The increase of SUA level is closely related to the occurrence and development of WML and can be considered to be the independent risk factor for ischemic WML in elderly patients.
keywords: Serum uric acid White matter lesions,ischemic Magnetic resonance imaging Age-related white matter change visual assessment
文章编号： 中图分类号：R 543.5 文献标志码：B
基金项目:
| Author Name | Affiliation |
| SONG Chang-cheng,ZHANG Ting,LV Ying-yue | Department of Geriatrics,Air Force Hospital of PLA Eastern Theater Command,Nanjing,Jiangsu 210002,China |
引用文本：
宋长城,张婷,吕颖钺.血尿酸水平与老年缺血性脑白质病变严重程度的相关性[J].中国临床研究,2019,32(6):794-798.
宋长城,张婷,吕颖钺.血尿酸水平与老年缺血性脑白质病变严重程度的相关性[J].中国临床研究,2019,32(6):794-798.