标题：广西三县痛风患者血脂水平及影响因素分析

      作者：李晓鹏，唐振柱，吴兴华，周为文，熊润松，陈玉柱，秦秋兰，李忠友，黄丽娜，朱耿赟    (广西壮族自治区疾病预防控制中心，广西 南宁 530028)

      卷次： 2017年28卷12期

      【摘要】 目的 分析广西三县痛风患者的血脂水平现状及影响因素，为痛风疾病的治疗与预防提供参考依据。方法 采用 1:1配对的病例-对照研究方法，在广西大化、三江县、合浦县开展相关研究，以 2015年 5月以县级及县级以上医院确诊的痛风病例作为痛风组(379例)，病例选定后，根据痛风组病例的基本信息，在对应病例的同一社区/村屯选出所有与患者同性别、年龄相近、无血缘关系且居住的非痛风、非高尿酸血症者作为健康组(379例)，共 758例。收集研究对象的一般情况、体格检查、实验室检验等数据，并进行单因素和多因素的Logistic回归分析。结果 痛风组患者血脂异常检出率为57.5%，混合型血脂异常检出率为38.3%，痛风组与对照组间血脂异常、混合型血脂异常、高甘油三酯(TG)、高总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、血尿酸(UA)、TG、TC、HDL-C水平比较差异均有统计学意义(P<0.05)；痛风组患者中的血脂正常组与异常组间UA、TG、TC、HDL-C、体重、BMI、腰围、收缩压、舒张压、血糖水平比较差异均有统计学意义(P<0.05)；超重、肥胖、高尿酸、高血压是痛风患者高 TG的主要影响因素(OR值分别为 2.226、6.667、2.900、1.727)；脂肪是高 TC的主要影响因素(OR=1.093)；超重、肥胖、高尿酸是血脂异常的主要影响因素(OR值分别为2.923、5.479、2.157)；肥胖、高尿酸、高血压是混合型血脂异常的主要影响因素(OR值分别为4.052、2.257、1.649)。结论 痛风患者的血脂异常率处于较高水平，对于痛风合并血脂异常的患者，应考虑血脂对痛风疾病的影响，改善血脂水平，达到治疗和预防痛风的目的。
      【关键词】 痛风；血脂异常；身体质量指数；尿酸
      【中图分类号】 R589.7 【文献标识码】 D 【文章编号】 1003—6350（2017）12—2046—05

Blood lipid level and its risk factors for patients with gout in three counties of Guangxi Province.
LI Xiao-peng,TANG Zhen-zhu, WU Xing-hua, ZHOU Wei-wen, XIONG Run-song, CHEN Yu-zhu, QIN Qiu-lan, LI Zhong-you,HUANG Li-na, ZHU Geng-yun. Guangxi Zhuang Autonomous Regional Center for Disease Control and Prevention,Nanning 530028, Guangxi, CHINA
【Abstract】 Objective To analyze the status and influencing factors of blood lipid level in patients with gout inthree counties of Guangxi Province, and to provide reference for the treatment and prevention of gout. Methods A 1:1matched case-control study was carried out in 379 cases of patients with gout confirmed by County and above-Countylevel hospitals in Dahua, Sanjiang, Hepu County in Guangxi Province in May 2015. According to the basic informationof the cases, 379 non-gout and non-hyperuricemia people of the same gender, age, no blood relationship with corre-sponding patients were chosen from the same community as the control group. The data of general situation, physicalexamination, laboratory test were collected and analyzed by single factor and multivariate logistic regression analysis.Results The dyslipidemia and mixed dyslipidemia prevalence of patients with gout were respectively 57.5% and38.3%. There were statistically significant differences between the gout group and the control group in the dyslipidemia,mixed dyslipidemia, hyper triglyceride (TG), hyper total cholesterol (TC), high density lipoprotein cholesterol (HDL-C),uric acid (UA) (P<0.05). There were statistically significant differences between the normal blood lipid groups and thedyslipidemia group of the gout patients in UA, TG, TC, HDL-C, weight, body mass index (BMI), waistline, systolic anddiastolic blood pressure (SBP and DBP), blood glucose (P<0.05). The risk factors of hyper TG were overweight, obesity,hyperuricemia and hypertension (ORs were respectively 2.226, 6.667, 2.900, 1.727); the risk factor of hyper TC was fat(OR=1.093); the risk factors of dyslipidemia were obesity, hyperuricemia and hypertension (ORs were respectively2.923, 5.479, 2.157); the risk factors of mixed dyslipidemia were obesity, hyperuricemia and hypertension (ORs were re-sptectively 4.052, 2.257, 1.649). Conclusion The dyslipidemia prevalence of patients with gout is at a higher level. So,to achieve the purpose of treatment and prevention of gout, the impact of blood lipids on gout disease should be consid-ered to improve blood lipid levels in patients with dyslipidemia.
      【Key words】 Gout; Dyslipidemia; Body mass index (BMI); Uric acid (UA)·调查研究·doi:10.3969/j.issn.1003-6350.2017.12.053基金项目：国家自然科学基金(编号：81660568)