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目的探讨血尿酸水平变化与臂踝动脉脉搏波传导速度(baPWV)的关系。方法在2006-2007年参加健康体检的开滦集团职工101 510人中随机分层抽取5852人作为研究对象,进行统一问卷调查、血液生化检查,符合入选标准的(年龄≥40岁、既往无缺血性脑卒中、短暂性脑缺血发作、心肌梗死者)5440人纳入研究队列。依据2006-2007年度、2010-2011年度两次血尿酸数据将观察对象分为4组:2006-2007年度和2010-2011年度健康体检血尿酸均在正常水平者为Q1组(n=3845);2006-2007年度健康体检为高尿酸血症(HUA),至2010-2011年度健康体检血尿酸水平正常者为Q2组(n=252);2006-2007年度健康体检血尿酸正常,至2010-2011年度健康体检为HUA者为Q3组(n=285);2006-2007年度和2010-2011年度健康体检均为HUA者为Q4组(n=206)。采用多因素线性回归模型分析不同年度血尿酸水平与baPWV的关系,多因素Logistic回归模型分析血尿酸变化对baPWV≥14m/s占比的影响。结果 2010-2011年度健康体检时Q2、Q3、Q4组baPWV水平[(17.03±3.96)、(16.61±4.04)、(18.22±4.76)比(15.48±3.79)m/s;均P<0.01]和baPWV≥14 m/s的占比(76.2%、70.5%、83.5%比58.2%;均P<0.01)高于Q1组。不同年度血尿酸与baPWV的多因素线性回归分析结果显示,校正年龄、收缩压等因素后,2006-2007年度血尿酸每增加1μmol/L,2010-2011年度baPWV增加0.17cm/s;2010-2011年度血尿酸每增加1μmol/L,2010-2011年度baPWV增加0.11cm/s。影响baPWV≥14m/s的占比的多因素Logistic回归分析显示:校正了年龄、收缩压等因素后,与Q1组相比,Q2、Q3、Q4组检出baPWV≥14m/s的OR值分别为1.49(95%CI1.02~2.18)、1.47(95%CI1.04~2.06)、1.61(95%CI1.02~2.55)。结论尿酸波动可能是baPWV增加的危险因素,因此建议尿酸持续维持在正常水平。
Objective To investigate the relationship between the changes of blood uric acid level and the ankle-brachial artery pulse wave velocity (baPWV). Methods A total of 5852 workers from Kailuan Group, who participated in the physical examination from 2006 to 2007, were stratified randomly from 5,852 people who were investigated by questionnaires and blood biochemical tests, which met the inclusion criteria (age 40 years or older, Bloody stroke, transient ischemic attack, myocardial infarction) 5440 were included in the study cohort. According to the data of two blood uric acid levels from 2006 to 2007 and 2010-2011, the subjects were divided into four groups: the Q1 group (n = 3845), with normal blood uric acid levels in healthy subjects in 2006-2007 and 2010-2011; 2006-2007 year physical examination for hyperuricemia (HUA), to the 2010-2011 year healthy blood test for the normal level of Q2 group (n = 252); 2006-2007 healthy blood uric acid test normal to 2010-2011 The patients with HUA in the annual physical examination were Q3 (n = 285); those with healthy HUA in 2006-2007 and 2010-2011 were Q4 (n = 206). Multivariate linear regression model was used to analyze the relationship between serum uric acid levels and baPWV in different years. Multivariate Logistic regression model was used to analyze the effect of changes in serum uric acid on the proportion of baPWV≥14 m / s. Results The levels of baPWV in Q2, Q3 and Q4 were significantly higher than those in Q2, Q3 and Q4 (P <0.01) and (16.03 ± 3.96), (16.61 ± 4.04) and (18.22 ± 4.76) The proportion of baPWV≥14 m / s (76.2%, 70.5%, 83.5% vs 58.2%; both P <0.01) was higher than that of Q1 group. The results of multivariate linear regression analysis of serum uric acid and baPWV in different years showed that baPWV increased by 0.17 cm / s for every year from 2006 to 2007 after the adjustment of age and systolic blood pressure. For 2010-2011 Annual increase in serum uric acid 1μmol / L, 2010-2012 increased baPWV 0.11cm / s. The multivariate Logistic regression analysis of the proportion of patients with baPWV≥14m / s showed that the OR of baPWV≥14m / s detected by Q2, Q3 and Q4 were significantly higher than that of Q1 1.49 (95% CI 1.02 ~ 2.18), 1.47 (95% CI 1.04 ~ 2.06), 1.61 (95% CI 1.02 ~ 2.55). Conclusion Uric acid fluctuations may be an increased risk factor for baPWV, therefore, uric acid is recommended to maintain normal levels.