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持续非卧床腹膜透析患者的血清尿酸与内皮功能障碍

Serum uric acid and endothelial dysfunction in continuous ambulatory peritoneal dialysis patients.

作者信息

Tang Ziyong, Cheng Li-Tao, Li Hong-Yan, Wang Tao

机构信息

Division of Nephrology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, China.

出版信息

Am J Nephrol. 2009;29(5):368-73. doi: 10.1159/000168484. Epub 2008 Oct 31.

DOI:10.1159/000168484
PMID:18974637
Abstract

UNLABELLED

Endothelial dysfunction is an early predictor of cardiovascular events. Hyperuricemia has been shown to be associated with increased cardiovascular mortality. It remains unclear if serum uric acid (UA) is associated with endothelial dysfunction in peritoneal dialysis patients.

METHODS

In this cross-sectional study, the relationship of UA and endothelial dysfunction was investigated in 189 stable peritoneal dialysis patients. The clinical and laboratory data were collected. Endothelial function was estimated by flow-mediated dilatation (FMD) of the brachial artery and expressed as percentage change relative to baseline diameter.

RESULTS

UA levels did not differ between 93 male and 96 female patients (416.31 +/- 86.93 vs. 395.52 +/- 87.47 mumol/l, p > 0.05). Patients were grouped into three tertiles on the basis of their serum UA levels. Systolic blood pressure (p = 0.007), serum phosphate (p = 0.005), high-sensitive C-reactive protein (hs-CRP) (p < 0.001), and FMD (p = 0.016) were all different among UA tertiles. FMD was found to be related with UA (p = 0.002) and hs-CRP (p = 0.006) in a Pearson's correlation analysis. Multivariate regression analysis showed that only UA was an independent determinant of FMD (beta = -0.237, p = 0.036).

CONCLUSION

There was an independent correlation between UA and FMD, and a higher UA level was related to worse endothelial function which may contribute to hypertension and cardiovascular morbidity.

摘要

未标注

内皮功能障碍是心血管事件的早期预测指标。高尿酸血症已被证明与心血管死亡率增加有关。尚不清楚血清尿酸(UA)是否与腹膜透析患者的内皮功能障碍有关。

方法

在这项横断面研究中,对189例稳定的腹膜透析患者进行了UA与内皮功能障碍关系的研究。收集了临床和实验室数据。通过肱动脉血流介导的血管舒张(FMD)评估内皮功能,并表示为相对于基线直径的百分比变化。

结果

93例男性患者和96例女性患者的UA水平无差异(416.31±86.93对395.52±87.47μmol/L,p>0.05)。根据血清UA水平将患者分为三个三分位数组。收缩压(p = 0.007)、血清磷酸盐(p = 0.005)、高敏C反应蛋白(hs-CRP)(p<0.001)和FMD(p = 0.016)在UA三分位数组之间均有差异。在Pearson相关性分析中,发现FMD与UA(p = 0.002)和hs-CRP(p = 0.006)相关。多变量回归分析显示,只有UA是FMD的独立决定因素(β=-0.237,p = 0.036)。

结论

UA与FMD之间存在独立相关性,较高的UA水平与较差的内皮功能相关,这可能导致高血压和心血管疾病。

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