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热带海岛人群高尿酸血症与泌尿系结石的流行病学调查

Epidemiological investigation on the prevalence of hyperuricemia and urinary calculi in tropical island population

摘要目的:调查热带海岛人群中高尿酸血症的流行情况,分析高尿酸血症及痛风患者并发泌尿系结石的危险因素。方法:选取接受年度体检的638例热带海岛人群样本作为研究对象,收集一般资料、肾功能指标及泌尿系超声检查资料,采用组间对比及Logistic回归方法进行统计学分析。结果:热带海岛人群的高尿酸血症发生率为36.4%,痛风发生率为1.3%。泌尿系结石在尿酸正常、单纯高尿酸血症和痛风人群中的发生率分别为14.3%、23.9%和72.7%。人群中肌酐与尿酸水平呈正相关( r=0.25, P<0.001),而尿素氮随着尿酸的升高而略有上升( r=0.07, P=0.051)。血尿酸升高( OR=1.0, P=0.013)和痛风发作史( OR=7.9 ,P=0.004)是热带海岛人群发生泌尿系结石的危险因素,两者联合预测泌尿系结石发生的ROC曲线下面积(AUC)为0.601,略高于血尿酸水平单独预测时的0.598( P=0.158)。 结论:热带海岛人群中尿酸异常升高比例显著高于其他地区人群,且肌酐和尿素氮水平变化与尿酸水平变化呈正相关。血尿酸升高和痛风发作史是热带海岛人群发生泌尿系结石的危险因素,两指标联合应用对于泌尿系结石的发生具有一定预测性。

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abstractsObjective:To investigate the prevalence of hyperuricemia in tropical island population,and to analyze the risk factors of urinary calculi in patients with hyperuricemia or gout.Methods:A total of 638 samples of tropical island people who received annual physical examinations were the subjects of our study. Their general information,renal function indicators,and urological ultrasound data were collected. The intergroup comparison and binary Logistic regression were applied for statistical analysis.Results:The incidences of hyperuricemia and gout were 36.4% and 1.3%,respectively,in tropical island population. The incidences of urinary calculi in cases with normal uric acid,asymptomatic hyperuricemia,and gout were 14.3%,23.9%,and 72.7%,respectively. A positive correlation was found between serum creatinine and uric acid levels among the 638 cases( r = 0.25, P < 0.001),and the level of urea nitrogen increased slightly with the increase of uric acid( r = 0.07, P = 0.051). The elevated serum uric acid( OR = 1.0, P = 0.013)and history of gout( OR = 7.9, P = 0.004)were risk factors for the occurrence of urinary calculi in tropical island population. The combination of these two parameters could predict the occurrence of urinary calculi with AUC = 0.601,which was slightly better than using serum uric acid level alone with AUC = 0.598( P = 0.158). Conclusion:The proportion of patients with hyperuricemia in tropical islands is significantly higher than that in non-tropical regions. The serum creatinine and urea nitrogen levels are positively correlated with uric acid levels among the cases. The elevated serum uric acid and history of gout are risk factors for the occurrence of urinary calculi in tropical island population. The combination of these two parameters has a certain role in predicting the occurrence of urinary calculi.

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作者 张威 [1] 杨宾 [2] 李浩维 [3] 施晓磊 [1] 叶宸 [1] 刘曼娇 [4] 学术成果认领
作者单位 海军军医大学第一附属医院泌尿外科,上海 200433 [1] 海军第九二九医院泌尿外科,上海 200433 [2] 海军第九二九医院超声诊断科,上海 200433 [3] 海军第九二九医院检验病理输血科,上海 200433 [4]
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DOI 10.3760/cma.j.cn311847-20210607-00178
发布时间 2025-04-22
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