查旭雯 夏光云

摘要：目的  探討痛风患者血尿酸水平以及炎性因子C反应蛋白（CRP）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）水平的变化，并对其进行相关性分析。方法  选择2018年5月～2019年2月我院收治的52例痛风患者作为患者组，选取同期52名健康受试者作为对照组。检测两组受试者的血尿酸及CRP、IL-6、TNF-α的水平;采用Pearson相关分析评估血尿酸与炎性因子水平的相关性;采用ROC曲线法评估CRP、IL-6、TNF-α联合血尿酸对痛风诊断的曲线下方面积（AUC）、灵敏度和特异性。结果  患者组血尿酸、CRP、IL-6、TNF-α水平均高于对照组，差异具有统计学意义（P<0.05）。血尿酸与CRP（r=0.193，P=0.050）、IL-6（r=0.225，P=0.021）、TNF-α（r=0.342，P=0.000）的水平均呈正相关关系。CRP、IL-6、TNF-α联合血尿酸水平诊断痛风的AUC面积分别为0.824（灵敏度为86.30%，特异性为67.30%）、0.811（灵敏度为80.40%，特异性为73.10%）、0.989（灵敏度为100.00%，特异性为96.20%）。结论  痛风患者升高的血尿酸水平可能与循环中的炎性因子密切相关，且炎性因子的水平对于痛风的诊断具有一定的指导意义。

关键词：痛风;尿酸;炎性因子;诊断

中图分类号：R589.7                                  文献标识码：A                                DOI：10.3969/j.issn.1006-1959.2019.15.058

文章编号：1006-1959（2019）15-0170-03

Abstract：Objective  To investigate the changes of serum uric acid level， inflammatory factor C-reactive protein （CRP）， interleukin-6 （IL-6） and tumor necrosis factor-α （TNF-α） levels in patients with gout， and to analyze their correlation.Methods  A total of 52 patients with gout admitted to our hospital from May 2018 to February 2019 were enrolled as the control group. 52 healthy subjects were selected as the control group. The levels of serum uric acid and CRP， IL-6 and TNF-α were measured in the two groups. The correlation between serum uric acid and inflammatory factors was evaluated by Pearson correlation analysis. The area under the curve （AUC）， sensitivity and specificity of CRP， IL-6， TNF-α combined with blood uric acid for gout diagnosis were evaluated by ROC curve method.Results  The levels of serum uric acid， CRP， IL-6 and TNF-α in the patients were higher than those in the control group， and the difference was statistically significant （P<0.05）. There was a positive correlation between serum uric acid and CRP （r=0.193，P=0.050），IL-6 （r=0.225，P=0.021）， and TNF-α （r=0.342，P=0.000）. The AUC areas of CRP， IL-6， TNF-α combined with blood uric acid level for the diagnosis of gout were 0.824 （sensitivity 86.30%， specificity 67.30%）， 0.811 （sensitivity 80.40%， specificity 73.10%）， 0.989 （ the sensitivity is 100.00% and the specificity is 96.20%）.Conclusion  The elevated blood uric acid level in gout patients may be closely related to inflammatory factors in the circulation， and the level of inflammatory factors has certain guiding significance for the diagnosis of gout.

综上所述，痛风患者升高的血尿酸水平可能与循环中的炎性因子存在联系，且炎性因子的水平对于痛风的诊断具有一定的指导意义。

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收稿日期：2019-3-19;修回日期：2019-3-29

編辑/杨倩