原发性痛风患者合并高脂血症对规律降尿酸药物治疗敏感性的影响

doi:10.3969/j.issn.1006-6233.2022.01.022

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摘要 目的:探讨合并高脂血症对原发性痛风患者规律降尿酸治疗敏感性的影响。方法:回顾性分析海南医学院第一附属医院风湿免疫科2020年4月至2021年6月收治的120例接受规律降尿酸治疗的原发性痛风患者临床资料,依据治疗敏感性情况分为敏感组78例和耐药组42例。收集并比较两组性别、年龄、病程、痛风家族史、血尿酸基线值和血脂指标[甘油三酯(Triglyceride,TG)、总胆固醇(Total cholesterol,TC)、低密度脂蛋白胆固醇(Low density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇(High density lipoprotein cholesterol ,HDL-C)]等相关资料,统计两组高脂血症检出情况,并分析与规律降尿酸治疗敏感性的内在关系。结果:耐药组病程、合并痛风石、痛风发作频率、高血压史、血尿酸基线值、血肌酐(Serum creatinine,Scr)水平均大于敏感组,差异有统计学意义(P<0.05)。耐药组血清TG(1.68±0.40)mmoL/L和高脂血症发生率38.10%高于敏感组(1.54±0.31)mmoL/L、12.82%,HDL-C(1.06±0.27)mmoL/L低于敏感组(1.21±0.23)mmoL/L,差异有统计学意义(P<0.05)。多因素Logistic回归分析,病程(OR=1.308,95% CI:)、高血尿酸基线值(OR=2.017,95% CI:1.426~2.608)、痛风石(OR=1.208,95% CI:1.031~1.385)、高血压史(OR=1.250,95% CI:1.071~1.429)、高脂血症(OR=1.529,95% CI:1.138~1.920)均是痛风患者规律降尿酸治疗敏感性较差的独立影响因素(P<0.05)。结论:原发性痛风患者规律降尿酸药物治疗敏感性的影响因素较多,合并高脂血症是治疗敏感性较差的独立危险因素,临床需引起重视。

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关键词 ：痛风, 降尿酸, 敏感性, 高脂血症, 相关性

Abstract：Objective: To explore the effect of hyperlipidemia on the sensitivity of regular uric acid lowering therapy in patients with primary gout. Methods: The clinical data of 120 gout patients treated with regular uric acid lowering therapy in the Department of Rheumatology and immunology of the tirsa affiliated hospital of Hainan Medical College from April 2020 to June 2021 were analyzed retrospectively. According to the treatment sensitivity, they were divided into sensitive group (78 cases) and drug-resistant group (42 cases). Gender, age, course of disease, family history of gout, baseline value of serum uric acid and blood lipid indexes triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) other relevant data were collected and compared between the two groups. The incidence of hyperlipidemia in the two groups was counted, The internal relationship between hyperlipidemia and the sensitivity of regular uric acid lowering therapy was analyzed. Results: The course of disease, combined with gout stone, frequency of gout attack, history of hypertension, baseline value of serum uric acid and serum creatinine (SCR) level in the drug-resistant group were significantly higher than those in the sensitive group (P< 0.05).The incidence of serum TG (1.68 ± 0.40) mmol / L and hyperlipidemia in the drug-resistant group was 38.10% higher than that in the sensitive group (1.54 ± 0.31) mmol / L and 12.82%, and HDL-C (1.06 ± 0.27) mmol / l was lower than that in the sensitive group (1.21 ± 0.23) mmol / L, the difference was statistically significant (P< 0.05). Multivariate logistic regression analysis showed that the course of disease (OR= 1.308, 95% CI:), higher baseline value of serum uric acid (OR= 2.017, 95% CI: 1.426 ~ 2.608), gout stone (OR = 1.208, 95% CI: 1.031 ~ 1.385), history of hypertension (OR= 1.250, 95% CI: 1.071 ~ 1.429), and hyperlipidemia (OR= 1.529, 95% CI: 1.138 ~ 1.920) were independent influencing factors of poor sensitivity of regular uric acid lowering therapy in patients with gout (P< 0.05).Conclusion: There are many influencing factors of uric acid lowering drug treatment sensitivity in patients with primary gout. Hyperlipidemia is an independent risk factor with poor treatment sensitivity, which deserves more attention in clinic.

Key words： Gout Reduce uric acid Sensitivity Hyperlipidemia Relevance

基金资助:海南省卫生健康行业科研项目,(编号:20A200111)

通讯作者: 李珑

引用本文:

王雪娇, 李娟, 焦凌梅, 陈静, 陈玉雅, 符白玉, 李珑. 原发性痛风患者合并高脂血症对规律降尿酸药物治疗敏感性的影响[J]. 河北医学, 2022, 28(1): 107-111.
WANG Xuejiao, et al. Effect of Hyperlipidemia in Patients with Primary Gout on the Sensitivity of Regular Uric Acid Lowering Drugs. HeBei Med, 2022, 28(1): 107-111.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2022.01.022 或 http://www.hbyxzzs.cn/CN/Y2022/V28/I1/107

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