高尿酸血症患者血清尿酸水平与红细胞相关参数的相关性

doi:10.3969/j.issn.1673-8640.2019.06.002

摘要/Abstract

摘要：

目的探讨高尿酸血症（HUA）患者血清尿酸（UA）水平与红细胞（RBC）参数的相关性。方法收集1 168例HUA患者（HUA组）和1 311名体检健康者（正常对照组）UA、RBC、血红蛋白（Hb）、平均红细胞血红蛋白含量（MCH）、平均红细胞血红蛋白浓度（MCHC）、红细胞分布宽度（RDW）、红细胞平均体积（MCV）等的检测结果。将所有研究对象按性别分组,再根据UA水平的四分位数对HUA患者进行再分组。采用Pearson线性相关分析、多因素线性回归分析及多因素二分类Logistic回归分析评估UA与RBC参数的相关性。结果男性之间比较,HUA组UA、MCH、MCHC、RBC、Hb水平明显高于正常对照组（P<0.05）;女性之间比较,HUA组UA、MCH、RDW、RBC、Hb水平明显高于正常对照组（P<0.05）,MCV水平明显低于正常对照组（P<0.001）。四分位数分组结果显示男、女性HUA患者RBC均随UA水平的升高而升高（P<0.001）,男性HUA患者RDW水平随UA水平的升高而下降（P<0.05）。Pearson线性相关分析结果显示,男性HUA患者UA与RBC呈正相关（r=0.119,P=0.002）,与RDW呈负相关（r=-0.017,P=0.005）;女性HUA患者UA与RBC呈正相关（r=0.180,P<0.001）。多因素二分类Logistic回归分析结果显示,男性HUA患者UA>0.46~0.49 mmol/L组及UA>0.49 mmol/L组的UA水平是RDW水平下降[比值比（OR）值分别为0.773、0.690]及RBC水平升高（OR值分别为1.938、1.787）的独立因素。女性HUA患者UA>0.41 mmol/L组UA水平是RBC水平升高的独立因素（OR=4.578）。多因素线性回归分析结果显示男性HUA患者UA水平与RBC呈正相关（B=0.128,P=0.019）,与RDW呈负相关（B=-0.119,P=0.004）;女性HUA患者UA水平与RBC呈正相关（B=0.296,P<0.001）。结论 HUA患者血清UA水平升高是RBC水平升高的独立因素。

关键词: 尿酸, 红细胞, 高尿酸血症, 相关性

Abstract:

Objective To investigate the relationship between serum uric acid（UA） and red blood cell（RBC） parameters in hyperuricemia（HUA） patients. Methods A total of 1 168 HUA patients（HUA group） and 1 311 healthy subjects（healthy control group） were enrolled. The results of UA,RBC count,hemoglobin（Hb）,mean corpuscular hemoglobin（MCH）,mean corpuscular hemoglobin concentration（MCHC）,red blood cell distribution width（RDW） and mean corpuscular volume（MCV） were collected. All the research subjects were classified into male and female groups,and HUA group was sub-classified according to the quartiles of UA. The relationship betweeen UA and RBC parameters was analyzed by Pearson analysis,multiple binary Logistic analysis and multiple linear regression analysis. Results The levels of UA, MCH,MCHC,RBC count and Hb were higher in HUA group than those in healthy control group for males（P<0.05）. The levels of UA,MCH,RDW,RBC count and Hb were higher in HUA group than those in healthy control group for females（P<0.05）,and the level of MCV was lower（P<0.001）. The increased RBC count was related with the increasing of UA levels for males and females（P<0.001）,and the decreased RDW level was related with the increasing of UA levels for males（P<0.05）. Pearson analysis showed that there were positive correlations between UA and RBC count in males（r=0.119,P=0.002） and in females（r=0.180,P<0.001）. There was a negative correlation between UA and RDW in males（r=-0.017,P=0.005）. Multiple binary Logistic analysis showed that the UA levels of male HUA patients with UA>0.46-0.49 mmol/L and UA>0.49 mmol/L were independent factors for the decreasing of RDW level [odds ratio（OR）=0.773 and 0.690,respectively] and the increasing of RBC count（OR=1.938 and 1.787,respectively）. The UA level of female HUA patients with UA>0.41 mmol/L was the independent factor for the increasing of RBC count（OR=4.578）. Multiple linear regression analysis showed that the level of UA was positively correlated with RBC count in males（B=0.128,P=0.019）. The level of UA was negatively correlated with RDW in males（B=-0.119,P=0.004）. The level of UA was positively correlated with RBC count in females（B=0.296,P<0.001）. Conclusions The increasing of UA level is an independent factor for the increasing of RBC count in patients with HUA.

Key words: Uric acid, Red blood cell, Hyperuricemia, Relationship

中图分类号:

R446.1

马峥尧, 郭玮, 潘柏申, 王蓓丽. 高尿酸血症患者血清尿酸水平与红细胞相关参数的相关性[J]. 检验医学, 2019, 34(6): 486-490.

MA Zhengyao, GUO Wei, PAN Baishen, WANG Beili. Relationship between serum uric acid and red blood cell parameters in hyperuricemia patients[J]. Laboratory Medicine, 2019, 34(6): 486-490.

图/表 5

参考文献 12

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组别	例数	UA（mmol/L）	MCH（pg）	MCHC（g/L）	MCV（fL）	RDW（%）	RBC（×1012/L）	Hb（g/L）
HUA组	1 168
男性	686	0.470±0.045**	30.95±1.61*	336.98±11.06*	91.92±4.69	12.93±0.71	4.66±0.44*	143.77±12.39**
女性	482	0.389±0.053**	30.23±1.63**	331.30±13.32	90.05±3.94**	13.02±0.74*	4.30±0.35**	128.15±9.75*
正常对照组	1 311
男性	759	0.321±0.052	30.75±1.54	335.18±11.76	91.80±4.34	12.93±0.70	4.58±0.48	140.75±13.49
女性	552	0.248±0.046	29.82±1.62	331.16±11.61	91.31±3.95	12.89±0.73	4.18±0.38	126.22±9.74

组别	例数	UA（mmol/L）	MCH（pg）	MCHC（g/L）	MCV（fL）	RDW（%）	RBC（×1012/L）	Hb（g/L）
HUA组	1 168
男性	686	0.470±0.045**	30.95±1.61*	336.98±11.06*	91.92±4.69	12.93±0.71	4.66±0.44*	143.77±12.39**
女性	482	0.389±0.053**	30.23±1.63**	331.30±13.32	90.05±3.94**	13.02±0.74*	4.30±0.35**	128.15±9.75*
正常对照组	1 311
男性	759	0.321±0.052	30.75±1.54	335.18±11.76	91.80±4.34	12.93±0.70	4.58±0.48	140.75±13.49
女性	552	0.248±0.046	29.82±1.62	331.16±11.61	91.31±3.95	12.89±0.73	4.18±0.38	126.22±9.74

UA （mmol/L）	例数	年龄（岁）	BMI （kg/m2）	MCH （pg）	MCHC （g/L）	MCV（fL）	RDW（%）	RBC（×1012/L）	Hb （g/L）
≤0.43	176	59.27±11.65	22.53±2.99	31.09±1.72	337.23±11.46	92.24±4.94	13.01±0.69	4.59±0.44	142.55±12.35
>0.43~0.46	174	56.77±10.20	22.27±3.08	30.92±1.70	337.93±11.36	91.55±4.77	13.01±0.71	4.48±0.45	144.19±13.66
>0.46~0.49	168	57.85±12.74	22.70±2.94	30.96±1.64	335.33±10.68	92.41±4.99	12.85±0.73	4.72±0.43	143.73±12.09
>0.49	168	58.43±12.03	22.48±3.06	30.84±1.26	337.38±10.61	91.46±3.94	12.83±0.69	4.70±0.40	144.65±11.32
F值		1.409	0.607	0.727	1.780	1.775	3.233	11.311	0.921
P值		0.239	0.611	0.536	0.150	0.151	0.022	<0.001	0.430

UA （mmol/L）	例数	年龄（岁）	BMI （kg/m2）	MCH （pg）	MCHC （g/L）	MCV（fL）	RDW（%）	RBC（×1012/L）	Hb （g/L）
≤0.43	176	59.27±11.65	22.53±2.99	31.09±1.72	337.23±11.46	92.24±4.94	13.01±0.69	4.59±0.44	142.55±12.35
>0.43~0.46	174	56.77±10.20	22.27±3.08	30.92±1.70	337.93±11.36	91.55±4.77	13.01±0.71	4.48±0.45	144.19±13.66
>0.46~0.49	168	57.85±12.74	22.70±2.94	30.96±1.64	335.33±10.68	92.41±4.99	12.85±0.73	4.72±0.43	143.73±12.09
>0.49	168	58.43±12.03	22.48±3.06	30.84±1.26	337.38±10.61	91.46±3.94	12.83±0.69	4.70±0.40	144.65±11.32
F值		1.409	0.607	0.727	1.780	1.775	3.233	11.311	0.921
P值		0.239	0.611	0.536	0.150	0.151	0.022	<0.001	0.430

UA （mmol/L）	例数	年龄（岁）	BMI （kg/m2）	MCH （pg）	MCHC （g/L）	MCV（fL）	RDW（%）	RBC（×1012/L）	Hb （g/L）
≤0.35	176	60.91±12.12	22.47±3.09	29.86±2.05	331.88±18.52	90.01±4.00	12.99±0.78	4.24±0.42	127.36±9.69
>0.35~0.37	174	59.58±12.98	22.70±3.23	29.74±1.36	330.92±9.51	89.90±3.78	13.04±0.65	4.30±0.34	127.59±9.23
>0.37~0.41	168	59.46±13.26	22.06±2.71	29.75±1.39	330.34±9.53	90.09±3.81	13.03±0.76	4.32±0.33	128.43±9.32
>0.41	168	61.36±13.41	22.41±3.40	29.93±1.41	331.97±11.18	90.19±4.18	13.04±0.71	4.45±0.32	129.45±10.72
F值		0.632	0.835	0.360	0.434	0.100	0.190	7.080	1.110
P值		0.595	0.475	0.782	0.729	0.960	0.903	<0.001	0.345