FANG Danhong,WU Gaojun.. Effect of hyperuricemia on hemodynamics and left ventricular diastolic dysfunction in primary hypertension[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2023, 53(10): 782-788，794.
摘要目的：分析未控制的原发性高血压患者高尿酸血症（HU）对血流动力学的影响，并探讨HU和左心室舒张功能减退之间的关系。方法：选取2022 年8月至12月在温州医科大学附属第一医院就诊的189 例未控制的高血压患者，分为合并HU组（81例）和非HU组（108 例）。对2组患者人口学、合并病史、生化指标、心脏超声指标以及无创血流动力学指标进行比较。采用多因素Logistic回归分析探讨HU和高血压患者左心室舒张功能减退之间的关系。结果：合并HU组大动脉硬化指数显著低于非HU组（0.70±0.27 vs. 0.81±0.32，P=0.01）。合并HU组和非HU组患者间大动脉高阻力型比例（60.49% vs. 65.74%）和外周血管高阻力型比例（85.18% vs. 80.56%）差异无统计学意义（P ＞0.05）。调整相关协变量后，多因素Logistic回归分析显示，HU和高血压患者左心室舒张功能减退独立相关（调整OR =5.05，95%CI =1.87～13.58，P =0.001）。结论：HU影响高血压患者的血流动力学特征；HU是高血压左心室舒张功能减退的独立危险因素。
Abstract：Objective: To analyze the effect of hyperuricemia (HU) on hemodynamic, and to explore the relationship between HU and left ventricular diastolic dysfunction in patients with uncontrolled primary hypertension. Methods: An observational study was conducted in 189 patients with uncontrolled hypertension who visited the First Affiliated Hospital of Wenzhou Medical University from August to December 2022. They were divided into hypertension with HU group (81 cases) and hypertension with non-HU group (108 cases). The demography, history of concomitant diseases, biochemical indicators, cardiac ultrasound indicators and noninvasive hemodynamic indicators were compared between the two groups. The relationship between HU and left ventricular diastolic dysfunction in hypertensive patients was investigated by multivariate logistic regression analysis. Results: The arterial stiffness index (ASI) in HU group was significantly lower than that in non-HU group (0.70±0.27 vs. 0.81±0.32, P=0.01). The hemodynamic phenotyping showed that the proportion of arterial vascular phenotype (high AS) and systemic vascular phenotype (high SVRI) in HU group and non-HU group was 60.49% vs. 65.74% and 80.56% vs. 85.18%, respectively, indicating no significant difference between the two groups (P>0.05). After adjusting the confounding covariates, multivariate Logistic regression analysis showed that HU was independently associated with left ventricular diastolic dysfunction in patients with hypertension (adjusted OR=5.05, 95%CI=1.87-13.58, P=0.001). Conclusion: HU affects the hemodynamic characteristics of primary hypertensive patients; HU is an independent risk factor for left ventricular diastolic dysfunction in hypertension.
