目的: 分析探讨住院病人2 型糖尿病肾脏疾病( T2DKD) 尿酸升高与代谢紊乱的关系及其危险因素。
方法: 收集105 例糖尿病肾脏疾病( DKD) 住院病人临床实验室资料，根据血尿酸浓度将105 例DKD 病人分为高
尿酸组和正常尿酸组，分别检测两组血压、人体测量学指数、糖化血红蛋白、血脂、血尿酸、血肌酐及24h 尿蛋白
定量等指标，明确高尿酸血症( HUA) 与DKD 代谢紊乱的关系及其危险因素。结果: 105 例病人中HUA 病人42
例，占40． 0%; 单因素分析发现男性、体重指数( BMI) ≥25 kg /m2、高血压、血肌酐( SCr) ≥110μmol /L、血尿素氮
( BUN) ≥7． 0 mmol /L、24h 尿蛋白( 24h－UAE) ≥0． 3g /24h、血甘油三酯( TG) ≥1． 70 mmol /L、血高密度脂蛋白
( HDL) ＜1． 04 mmol /L、血低密度脂蛋白( LDL) ≥3． 37 mmol /L 等因素影响HUA 的发生( P＜0． 05) ; Logistic 回归
分析提示BMI、SCr、TG 水平是影响DKD 发生HUA 的独立危险因素; 各主要危险因素在DKD 中均有较高的发生
率。结论: DKD 尿酸升高与多种危险因素有关，HUA 与DKD 代谢紊乱密切关联。

Objective: To investigate the association of elevated serum uric acid ( UA) with
metabolic disorders and the risk factors of 2 diabetic kidney disease( T2DKD) ． Methods: The clinical
and laboratory data of 105 T2DKD patients were analyzed to explore the association of hyperuricemia
( HUA) with metabolic disorders and identify the risk factors of HUA． Results: Forty of 105 DKD patients(
40． 0%) were found to have HUA． Univariate analysis showed that male gender，a body mass index
≥25 kg /m2，hypertension， serum creatinine ≥110μmol /L，blood urea nitrogen ≥7． 0 mmol /L，
24h－ UAE≥0． 3g /24h， triglyceride ≥1． 70 mmol /L，high － density lipoprotein ＜1． 04 mmol /L， low
density lipoprotein ≥3． 37 mmol /L were all risk factors of HUA( P＜0． 05) in DKD． Binary logistic regression
analysis identified body mass index， serum creatinine and triglyceride as independent risk factors
of HUA in DKD． The main risk factors related to HUA had high incidences in DKD． Conclusion:
Several risk factors contribute to the occurrence of elevated serum uric acid in DKD，and metabolic disorders
are also closely associated with HUA．

R589

 收稿日期: 2013－09－01; 修回日期: 2013－11－20
基金项目: 国际肾脏病学会资助项目发展中国家KHDC 项目先驱研究( 2004 － 2014 ) ; 广东省科技计划项目
( 2011B031800386)
作者简介: 张丽英( 1979－) ，女，内蒙古医科大学附属医院肾内科主治医师。