刘赢　许琳

[摘要]目的 探讨老年2型糖尿病合并高尿酸血症（HUA）的相关因素。方法 选取2013年1月～2014年1月在丹东第一医院内分泌科住院的2型糖尿病患者567例，分为高尿酸组（HUA）92例和尿酸正常组（NUA）475例，回顾性统计分析两组的临床及实验室资料。结果 T2DM合并HUA92例，总患病率为16.2%，且男性患病率显著高于女性（55.4% vs. 44.6%，P<0.05）；男性HUA患病率随年龄增长而上升，均高于女性（60～69岁：53.1%；70～79岁：57.1%；80～89岁：62.5% vs. 46.9%，42.9%，37.5%，P<0.05）。HUA组的病程明显长于NUA组，HbA1c、尿酸明显高于NUA组（P<0.05）。HUA组的心血管病变、糖尿病肾病、糖尿病周围神经病变、高血压患病率均较NUA组有升高趋势 （P>0.05）。多因素Logistic回归分析结果提示，性别（P=0.020，OR=0.582，95%CI =0.370～0.917 ）和病程（P=0.004，OR =1.053，95%CI= 1.017～1.091）为T2DM合并HUA的危险因素。结论 T2DM合并HUA的患病率较高，随着年龄的增长而增加，男性高于女性。病程、性别对尿酸水平有显著影响。

[关键词]2型糖尿病；高尿酸血症；慢性并发症；危险因素

[中图分类号] R587.1 [文献标识码] A [文章编号] 1674-4721（2017）07（b）-0065-04

[Abstract]Objective To study the related factors of in elderly patients with type 2 diabetes mellitus complicated with hyperuricemia.Methods A total of 567 patients with type 2 diabetes from January 2013 to January 2014 were selected and they were divided into the hyperuricemiad （HUA） and normal UA level （NUA group）.Their clinical and laboratory data were retrospectively counted and analyzed.Results Among 567 type 2 diabetes patient，92 patients were diagnosed with HUA （16.2%），and male patients had a significantly higher incidence rate of HUA group than female patients （55.4% vs 44.6%，P<0.05）.while the level of BUA kept increasing with age in the male， it was significantly higher than in the female （60 to 69 years old：53.1%；70 to 79 years old：57.1%；80 to 89 years old：62.5% vs. 46.9%，42.9%，37.5%，P<0.05）.The course of disease in group HUA was significantly longer than that in group NUA，and HbA1c and uric acid were significantly higher than those in group NUA （P<0.05）.The incidence rate of cardiovascular diseases，diabetic nephropathy，diabetic peripheral neuropathy and hypertension in the HUA group was higher than that in the NUA group （P>0.05）.Multivariate Logistic regression analysis showed that gender （P=0.020，OR=0.582，95%CI=0.370-0.917） and course of disease （P=0.004，OR=1.053，95%CI=1.017-1.091） were risk factors for T2DM complicated with HUA.Conclusion The prevalence of T2DM associated with HUA is higher and increased with age，and is higher in men than in women.The duration of disease and sex has significant influence on uric acid level.

[Key words]Diabetes mellitus；Hyperuricemia；Chronic complications；Risk factors

據相关报道，高尿酸血症（hyperuricemia，HUA）与糖尿病、肥胖、高血脂、高血压、高胰岛素血症等有一定相关性[1]。近年来随着人们生活水平的不断提高，饮食结构的改变，高尿酸血症的发病率呈逐年上升趋势，尤其以中老年糖尿病患者较为多见，随着年龄和病程的延长，发病率也不断增加[2]，可见HUA是T2DM的独立预测因子，因此，本研究通过分析老年T2DM合并HUA的相关影响因素，以引起人们对尿酸水平的进一步重视，为临床防治工作提供参考。

1资料与方法

1.1 一般资料

回顾性调查2013年1月～2014年1月在丹东第一医院内分泌科住院的2型糖尿病患者567例（男254例，女313例），年龄60～89岁，平均（68.81±6.44）岁，病程0～26年，平均（10.18±6.26）年。所有患者经医学伦理委员会批准，知情同意并签署知情同意书。

1.2 诊断标准

所有病例均符合1999年世界卫生组织（WHO）关于糖尿病的诊断标准，且筛查前没有使用促尿酸排泄的药物。依……