上海市郊区社区管理高血压患者高尿酸血症患病情况及其影响因素分析

吴菲; 杨美; 严青华; 常兆玉; 陈秋艳; 王玉恒; 杨沁平; 程旻娜; 徐健蓉; 孟杨; 施燕

doi:10.11847/zgggws1141964

上海市郊区社区管理高血压患者高尿酸血症患病情况及其影响因素分析

Prevalence and influencing factors of hyperuricemia among hypertensive patients registered at community health service centers in suburb of Shanghai: a cross-sectional survey

摘要

摘要:
目的了解上海市郊区社区管理高血压患者的高尿酸血症（HUA）患病情况及其影响因素，为基层医疗机构开展HUA的预防和管理提供参考依据。
方法于2021年10 — 12月采用单纯随机抽样方法在上海市宝山区罗店镇和罗泾镇2个社区卫生服务中心各抽取1800例登记管理的高血压患者进行问卷调查、体格检查和实验室检测，分析其HUA患病情况，并应用多因素非条件logistic回归模型分析上海市郊区社区管理高血压患者HUA患病的影响因素。
结果上海市郊区最终纳入分析的2899例社区管理高血压患者中，HUA患病882例，HUA患病率为30.42%；男性和女性社区管理高血压患者的HUA患病率分别为31.96%和29.15%，差异无统计学意义（P > 0.05）；多因素非条件logistic回归分析结果显示，高脂血症、慢性肾脏疾病和超重肥胖是上海市郊区社区管理高血压患者HUA患病的危险因素，糖尿病、服用血管紧张素受体拮抗剂（ARB）类和钙通道阻滞剂（CCB）类降压药物是上海市郊区社区管理高血压患者HUA患病的保护因素；高脂血症、慢性肾脏疾病和超重肥胖是上海市郊区社区管理男性高血压患者HUA患病的危险因素，糖尿病是上海市郊区社区管理男性高血压患者HUA患病的保护因素；年龄 ≥ 80岁、高脂血症、慢性肾脏疾病和超重肥胖是上海市郊区社区管理女性高血压患者HUA患病的危险因素，服用ARB类和CCB类降压药物是上海市郊区社区管理女性高血压患者HUA患病的保护因素。
结论上海市郊区社区管理高血压患者中HUA患病率较高，尤其要重视有高脂血症、慢性肾脏疾病和超重肥胖高血压患者血尿酸水平的变化，对已合并HUA的患者应谨慎选择降压药物。

Abstract:
Objective To explore the prevalence and determinants of hyperuricemia (HUA) among hypertensive patients registered at community health service centers in suburb of Shanghai for promoting prevention and management of HUA in primary health institutions.
Methods The participants of the study were 3 600 hypertensive patients randomly recruited from chronic disease patients registered at two community health service centers in a suburban district of Shanghai city. Face-to-face interview with a self-designed questionnaire and the International Physical Activity Questionnaire, physical examination, laboratory tests were conducted among the participants during October − December 2021. The prevalence of HUA was described and unconditional multivariate logistic regression analysis was used to analyze determinants of HUA.
Results Among the 2 899 eligible participants, 882 were identified as having HUA, with an overall prevalence of 30.42% and not significantly different gender-specific prevalence of 31.96% for the males and 29.15% for the females (P > 0.05). The results of unconditional multivariate logistic regression analysis indicated that hyperlipidemia, chronic kidney disease, overweight, and obesity were risk factors for HUA but suffering from diabetes, medication with angiotensin receptor blockers (ARBs) or with calcium channel blockers (CCBs) were protective factors against HUA for all the participants; while for the male participants, hyperlipidemia, chronic kidney disease, overweight, obesity were risk factors and suffering from diabetes was a protective factor; for the female participants, aged 80 years and above, hyperlipidemia, chronic kidney disease, overweight, obesity were risk factors but medication with ARBs or with CCBs were protective factors.
Conclusion The prevalence of HUA was relatively high in hypertensive patients at community health service centers in suburb of Shanghai. The result suggests that uric acid should be monitored among the hypertensive patients with chronic kidney disease, hyperlipidemia, overweight or obesity and antihypertensive drugs should be selected carefully for hypertensive patients complicated with HUA.

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