基础医学与临床 ›› 2020, Vol. 40 ›› Issue (4): 538-542.

• 临床研究 • 上一篇    下一篇

超声检查在高尿酸血症患者多脏器评估中的临床应用价值

高泽燕1,2, 刘晓月1, 陈丽萌3, 谭莉1, 张一休1, 李建初1, 吕珂1*   

  1. 1.中国医学科学院 北京协和医学院 北京协和医院 超声医学科,北京 100730;
    2.深圳市第二人民医院 超声科,广东 深圳 518035;
    3.中国医学科学院 北京协和医学院 北京协和医院 肾内科, 北京 100730
  • 收稿日期:2019-06-20 修回日期:2019-12-06 出版日期:2020-04-05 发布日期:2020-04-06
  • 通讯作者: *lvke@163.com
  • 基金资助:
    北京协和医学院小规模特色办学教育改革项目(10023201501007,10023201501009);深圳市医疗卫生三名工程项目(201612027)

Clinical value of ultrasonography in the evaluation of multiple organs in patients with hyperuricemia

GAO Ze-yan1,2, LIU Xiao-yue1, CHEN Li-meng3, TAN Li1, ZHANG Yi-xiu1, LI Jian-chu1, LYU Ke1*   

  1. 1. Department of Ultrasound, Peking Union Medical College Hospital, CAMS & PUMC, Beijing 100730;
    2. Department of Ultrasound, Shenzhen Second People's Hospital,Shenzhen 518035;
    3. Department of Nephrology,Peking Union Medical College Hospital, CAMS & PUMC,Beijing 100730, China
  • Received:2019-06-20 Revised:2019-12-06 Online:2020-04-05 Published:2020-04-06
  • Contact: *lvke@163.com

摘要: 目的 探讨与评估彩色多普勒超声在高尿酸血症患者多脏器评估中的临床应用价值。方法 纳入2015年7月至2017年5月于北京协和医院就诊的50例初治的高尿酸血症患者,记录血清尿酸(sUA)测值,应用彩色多普勒超声对每例患者的双侧第一跖趾关节、膝关节、肾脏、颈动脉及肝脏进行检查,评估sUA水平与上述脏器病变的相关性;进一步将研究对象分为痛风性关节炎(GA)组和无症状高尿酸血症(AH)组,分析并比较两组多脏器病变的情况。统计学方法采用卡方检验及Spearman相关分析。结果 本研究50例初治高尿酸血症患者中,超声显示关节病变的检出率56.0%,肾脏形态结构改变的检出率72.0%;非酒精性脂肪肝(NAFLD)的检出率64.0%,其中59.4%为中重度脂肪肝,sUA水平与NAFLD的检出率呈正相关(P<0.05);颈动脉粥样硬化的检出率36.0%,sUA水平与颈总动脉内中膜厚度呈正相关(P<0.05);关节、肾脏、肝脏、颈动脉中两个/两个以上脏器病变的检出率80.0%,sUA水平与多脏器病变的检出率呈正相关(P<0.05)。GA组与AH组之间关节病变及颈动脉粥样硬化检出率差异有统计学意义(P<0.05)。结论 彩色多普勒超声对于高尿酸血症患者关节病变和肾损害、非酒精性脂肪肝以及颈动脉粥样硬化等多脏器病变的早期诊断、全面评估病情进展和随访治疗后疗效具有一定的临床应用价值。

关键词: 高尿酸血症, 彩色多普勒超声, 关节, 肾脏, 多脏器病变

Abstract: Objective To explore and evaluate the clinical value of color Doppler ultrasound in the evaluation of multiple organs in patients with hyperuricemia. Methods The research included 50 patients with newly diagnosed hyperuricemia who were admitted to Peking Union Medical College Hospital from July 2015 to May 2017. Serum uric acid (sUA) was recorded and color Doppler ultrasound was used to examine the bilateral first metatarsophalangeal joint, knee joint, kidney, carotid artery and liver in each patient. The potential correlation between sUA level and organ lesions were searched. The subjects were further divided into gouty arthritis (GA) group and asymptomatic chyperuricemia (AH) group. The multiple organ diseases were analyzed and compared. Statistical methods used in cluded chi-square test and Spearman correlation analysis. Results In the 50 patients with newly diagnosed hyperuricemia, the rate of joint lesions diagnosed by ultrasound was 56.0%; the rate of renal morphological changes was 72.0%; the rate of nonalcoholic fatty liver disease (NAFLD) was 64.0%, of which 59.4% was moderate to severe fatty liver, and the sUA level was positively correlated with the detection rate of NAFLD(P<0.05),the detection rate of carotid atherosclerosis was 36.0%, and the level of sUA was positively correlated with the thickness of the common carotid artery (P<0.05).The detection rate of two or more organ lesions in joint, kidney, liver and carotid artery was 80.0%, and the level of sUA was positively correlated with the detection rate of multiple organ lesions (P<0.05). There was a significant difference in the detection rate of joint lesions and carotid atherosclerosis between the GA group and the AH group (P<0.05). Conclusions Color Doppler ultrasound has certain clinical application value for early diagnosis, comprehensive evaluation of lesion progression and follow-up treatment of multiple organ lesions such as joint lesions and renal damage, nonalcoholic fatty liver and carotid atherosclerosis in patients with hyperuricemia.

Key words: hyperuricemia, color Doppler ultrasound, joint, kidney, multiple organ lesions

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