中国临床医学2024，Vol.31Issue(3)：420-427,8.DOI:10.12025/j.issn.1008-6358.2024.20240202
血清尿酸水平与维持性血液透析患者死亡风险的相关性
Relationship between serum uric acid and mortality in maintenance hemodialysis patients
摘要
Abstract
Objective To investigate the effect of serum uric acid(SUA)on all-cause mortality and cardio-cerebrovascular diseases mortality in maintenance hemodialysis(MHD)patients.Methods Clinical data were retrospectively collected from MHD patients in Zhongshan Hospital,Fudan University from January 1,2015,to December 31,2016.The patients were categorized into low SUA group(SUA ≤ 399 μmol/L),medium SUA group(SUA 400-460 μmol/L),and high SUA group(SUA≥461 μmol/L)according to the tertiles of SUA level.The clinical data and laboratory examination results were compared among the three groups.The survival curves were plotted by Kaplan-Meier,and log-rank test were used to compare the survival rates among the three groups.Multivariate Cox regression was used to analyze the associations between SUA and all-cause mortality and cardio-cerebrovascular diseases mortality in MHD patients.Results A total of 436 MHD patients were enrolled,including 149 in low SUA group,144 in medium SUA group,and 143 in high SUA group.The median follow-up time was 59.7(38.4,60.9)months.During the follow-up,130 deaths were recorded,of which 90(69.2％)were due to cardio-cerebrovascular diseases.Kaplan-Meier survival analysis showed that the all-cause survival rate and cardio-cerebrovascular diseases survival rate of patients in low SUA group were lower than those in medium SUA group and high SUA group(P＜0.05).After adjusting for age,gender,comorbidities and other factors,the multivariate Cox regression analysis showed that the risk of all-cause mortality in patients decreased by 2.6％(HR=0.974,95％CI 0.952-0.996,P=0.022)and the risk of cardio-cerebrovascular diseases mortality decreased by 3.7％(HR=0.963,95％C1 0.937-0.991,P=0.008)for each 10 μmol/L increase in SUA level.The risks of all-cause mortality and cardio-cerebrovascular diseases mortality were significantly higher in low SUA group compared to high SUA group(HR=1.841,95％CI 1.138-2.979,P=0.013;HR=2.353,95％CI 1.288-4.300,P=0.005).Conclusions Low SUA level is independently associated with all-cause mortality and cardio-cerebrovascular diseases mortality in MHD patients.关键词
血液透析/尿酸/全因死亡/心脑血管疾病死亡Key words
hemodialysis/uric acid/all-cause mortality/cardio-cerebrovascular diseases mortality分类
医药卫生引用本文复制引用
黄英,曹学森,滕杰..血清尿酸水平与维持性血液透析患者死亡风险的相关性[J].中国临床医学,2024,31(3):420-427,8.基金项目
2023年福建省临床重点专科建设项目,厦门市科技计划项目(3502Z20194030).Supported by Fujian Provincial Key Clinical Specialty in 2023,Xiamen Science and Technology Plan Program(3502Z20194030). （3502Z20194030）
