摘要目的 研究男性痛风患者血浆致动脉硬化指数(AIP)与肾功能损害的相关性.方法 回顾性调查分析821例男性受检者,检测相关生化指标并计算AIP、内生肌酐清除率(Ccr)和估算的肾小球滤过率(eGFR).数据采用EpiData 3.1软件录入、SPSS 21.0进行统计学分析,图表采用GraphPad Prism 6.0软件绘制.结果 痛风组的AIP、血尿酸、三酰甘油均高于对照组(均P<0.01),而eGFR、高密度脂蛋白胆固醇低于对照组(P<0.05);痛风组肾功能损害的构成比明显高于对照组(P<0.01).随着AIP水平的升高,eGFR水平有所下降,血肌酐水平升高,但是总体差异无统计学意义(P>0.05);而Ccr和血尿酸水平逐渐升高(P<0.05).调整各种混杂因素后的logistic回归分析发现AIP、三酰甘油、血尿酸是痛风患者发生肾功能损害的相关危险因素(P<0.05),相关危险度分别为7.030、1.291、1.004.但是混杂因素调整前后三酰甘油、血尿酸与肾功能损伤相关危险度变化不大;而AIP表现更明显,OR值从2.629增至6.265和7.030.结论(1)AIP与痛风患者的肾功能损害密切相关,在调整各种混杂因素之后,AIP较其他指标更能反映肾功能损害.(2)对痛风患者肾功能损害程度的预测具有重要意义.(3)动态观察痛风患者AIP有助于早期识别该类患者肾功能衰竭的风险.

abstractsObjective To study the relationship between atherogenic index of plasma ( AIP ) and renal impairment in male patients with gout. Methods A retrospective analysis of 821 male subjects was conducted to measure the relevant biochemical indicators and to calculate the AIP, endogenous creatinine-clearance rate (Ccr), and estimated glomerular filtration rate ( eGFR) . EpiData 3.1 software was used for data entry, SPSS21.0 was used for statistical analysis, and GraphPad Prism 6. 0 software was used for charts. Results Compared with control group, AIP, serum uric acid, triglyceride in gout group were significantly higher (all P<0.01), while eGFR and high density lipoprotein-cholesterol were significantly lower ( both P<0.05) . The composition ratio of renal function impairment in gout group was significantly higher (P<0.01). With the increase of AIP level, eGFR level decreased and serum creatinine level increased, but the overall difference was not statistically significant ( P>0.05) , while Ccr and serum uric acid levels gradually increased (P<0.05). Logistic regression analysis after adjusting for various confounding factors showed that AIP, triacylglycerol, and serum uric acid were risk factors for renal function damage in patients with gout (P<0.05), the relevant risk were 7.030, 1.291, 1.004 respectively, After adjusting corfounding factors, the associafions betwees triglyceride, serum uric acid and with renal function injury risk changed little, while AIP show more evident, the OR value increased from 2.629 to 6.265 and 7.030. Conclusions (1)AIP is closely related to the renal function damage of patients with gout. After adjusting various confounding factors, AIP can better reflect the renal function damage than other indicators, which is of great significance to predict the renal function damage of patients with gout. ( 2) That patients with gout with high uric acid level may suffer from renal atherosclerosis and have a higher risk of renal impairment. ( 3) Dynamic observation of AIP in gout patients is helpful for early identification of the risk of renal failure in such patients.