| 引用本文： |
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赵苗苗,张杰,李觉.ASCVD患者HUA与CKD的交互作用对全因死亡及心血管死亡的影响[J].同济大学学报（医学版）,2015,36(5):111-115. [点击复制]
- ZHAO Miao-miao,ZHANG Jie,LI Jue.Interactive effects of hyperuricemia and chronic kidney disease on all-cause and cardiovascular disease mortality in patients with arteriosclerotic cardiovascular disease[J].同济大学学报（医学版）,2015,36(5):111-115. [点击复制]
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| 摘要: |
| 目的 研究动脉粥样硬化性心血管疾病(arteriosclerotic cardiovascular disease, ASCVD)患者中高尿酸血症(hyperuricemia, HUA)与慢性肾病(chronic kidney disease, CKD)的关系,同时探讨两者的交互作用对全因死亡及心血管疾病(cardiovascular disease, CVD)死亡的影响。方法 选取北京和上海8所大学附属医院年龄≥35岁且具有完整基线资料的ASCVD患者2810例,经过(57.6±23.2)个月的随访,2429例具有完整的随访资料,进入最终统计分析。根据研究对象基线的HUA及CKD水平,将其分为4组: 非HUA/非CKD组、HUA组、CKD组和HUA/CKD组。结果 根据血清尿酸(serum uric acid, SUA)四分位分组,第1~4组CKD的患病率分别为9.72%、20.59%、26.55%、44.52%(P＜0.001)；正常组、轻、中、重度CKD组HUA的患病率分别为15.82%、34.99%、58.90%、64.62%(P＜0.001)。以非HUA/非CKD组为对照,经Cox回归分析调整相关协变量,HUA组、CKD组及HUA/CKD组发生全因死亡的相对危险度分别为1.389(95%CI: 1.046~1.845)、1.476(95%CI: 1.165~1.870)、2.026(95%CI: 1.595~2.573)；发生CVD死亡的相对危险度分别为1.440(95%CI: 1.003~2.067)、1.611(95%CI: 1.198~2.166)、2.206(95%CI: 1.634~2.978)。结论 在ASCVD患者中,CKD患病率随着SUA水平的升高有增加的趋势；随着CKD病情的加重,HUA的患病率逐渐升高。HUA与CKD的交互作用可以增加ASCVD患者全因死亡及心血管死亡发生的可能。 |
| 关键词: 动脉粥样硬化性心血管疾病 高尿酸血症 慢性肾病 全因死亡 心血管死亡 |
| DOI：10.16118/j.1008-0392.2015.05.024 |
| 投稿时间：2015-04-29 |
| 基金项目:上海市气象与健康重点实验室开放基金(QXJK201404) |
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| Interactive effects of hyperuricemia and chronic kidney disease on all-cause and cardiovascular disease mortality in patients with arteriosclerotic cardiovascular disease |
| ZHAO Miao-miao,ZHANG Jie,LI Jue |
| (Heart, Lung and Blood Vessel Center, Medical College, Tongji University, Shanghai 200092, China) |
| Abstract: |
| Objective To investigate the interactive effects of hyperuricemia(HUA)and chronic kidney disease(CKD)on all-cause and cardiovascular disease(CVD)mortality in patients with arteriosclerotic cardiovascular disease(ASCVD). Methods A total of 2810 inpatients with ASCVD aged 35 y or older were enrolled from 8 university-affiliated hospitals in Beijing and Shanghai. During the follow-up time of(57.6±23.2)months, complete follow-up data were obtained from 2429 of them. Patients were divided into four groups based on their HUA and CKD status in baseline: no HUA/no CKD, HUA alone, CKD alone and HUA/CKD. Results The prevalence of CKD in patients with the first, second, third and fourth quartile of serum uric acid(SUA)were 9.72%, 20.59%, 26.55% and 44.52%(P＜0.001). The prevalence of HUA were 15.82%, 34.99%, 58.90% and 64.62% among patients with no, mild, moderate and severe CKD(P＜0.001). The multiple Cox regression analysis with adjustment for related covariates indicated that compared with the no HUA/no CKD group, the relative risks(RR)for all-cause mortality in groups of HUA alone, CKD alone and HUA/CKD were 1.389(95%CI: 1.046-1.845), 1.476(95%CI: 1.165-1.870)and 2.026(95%CI: 1.595-2.573). The RRs for CVD mortality were 1.440(95%CI: 1.003-2.067), 1.611(95%CI: 1.198-2.166)and 2.206(95%CI: 1.634-2.978). Conclusion A high risk of CKD is independently associated with a high SUA level. The prevalence of HUA increases gradually with the aggravation of CKD. HUA and CKD interactively affects all-cause and CVD mortality among patients with ASCVD. |
| Key words: arteriosclerotic cardiovascular disease hyperuricemia chronic kidney disease all-cause mortality cardiovascular disease mortality |
