无症状高尿酸血症患者凝血功能相关指标分析
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南京医科大学第一附属医院检验学部

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江苏省“科教强卫”实验诊断学重点实验室项目(编号:ZDXKB2016005)


Analysis of coagulation function correlative indexes in asymptomatic hyperuricemia patients
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    摘要:

    目的 探讨无症状高尿酸血症患者凝血功能相关指标的变化,及随着血清尿酸(serum uric acid, SUA)水平增高,SUA与凝血功能的关系。方法 收集2018年1月至2021年9月于江苏省人民医院健康管理中心进行健康体检人群共2389例,其中男性1497例,女性892例。由于男性、女性SUA水平的差异,故将其分开讨论。比较无症状高尿酸血症患者凝血功能相关指标[凝血酶原时间(prothrombin time, PT)、活化部分凝血活酶时间(activated partial thromboplastin time, APTT)、纤维蛋白原(fibrinogen, FIB)、凝血酶时间(thrombin time, TT)、D-二聚体(D-dimer, DD)和血小板(platelet, PLT)]。根据SUA四分位水平将男性、女性各分为四组,分析随着SUA水平的增高,凝血功能相关指标的变化,以及SUA与凝血功能相关指标的相关性。结果 男性无症状高尿酸血症患病率明显高于女性(P<0.001)。男性、女性无症状高尿酸血症患者血浆PT缩短,血浆FIB、全血PLT水平上升(均P<0.05)。随着SUA水平的升高,男性不同组别间血浆PT、FIB、全血PLT差异有统计学意义(均P<0.05),女性不同组别间血浆PT差异有统计学意义(P<0.05)。男性SUA水平与血浆PT、DD呈负相关,与血浆FIB、全血PLT水平呈正相关(均P<0.05),女性SUA水平与血浆PT呈负相关,与血浆FIB、TT呈正相关(均P<0.05)。结论 血清高尿酸水平可增加血浆黏度,活化血小板,影响外源性凝血功能,提示临床诊治中对无症状高尿酸血症的正确认识和及时干预,建议按时常规体检,为早期预防凝血功能异常性疾病提供有效保障。

    Abstract:

    Objective To study the changes of coagulation indexes in patients with asymptomatic hyperuricemia, and analyze its correlation with the increasing serum uric acid (SUA) level. Methods Data were collected from 2389 patients who have taken physical examinations in the Health Management Center of Jiangsu province Hospital from January 2018 to September 2021, including 1497 males and 892 females. Due to the difference in SUA levels between males and females, they were discussed separately. The following coagulation indexes of patients with asymptomatic hyperuricemia were analyzed: prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), thrombin time (TT), D-dimer (DD) and platelet (PLT). The data of males and females were separately divided into four groups according to the SUA quartile level. With the increase of the SUA level, the changes of coagulation indexes and its correlation with SUA were analyzed. Results The prevalence of asymptomatic hyperuricemia was significantly higher in males than that in females(P<0.001). Both in male and female asymptomatic hyperuricemia patients, data displayed shortened plasma PT(P<0.05), while the levels of FIB and PLT increased(P<0.05). With the increase of SUA level, there were statistically significant differences in PT, FIB and PLT among different groups in males (P<0.05), and there existed statistically significant difference in plasma PT among different female groups (P<0.05). The SUA level of male patients was negatively correlated with PT nor DD, and positively correlated with FIB and PLT(P<0.05). The SUA level of female patients was negatively correlated with PT, and positively correlated with FIB and TT(P<0.05).Conclusion The high SUA levels can increase plasma viscosity, activate platelets and affect exogenous coagulation function, suggesting correct recognition and timely intervention of asymptomatic hyperuricemia in clinical diagnosis and treatment. Periodic physical examination is highly recommended in order to provide effective guarantee for early prevention of coagulation disorders.

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  • 收稿日期:2021-12-28
  • 最后修改日期:2022-04-12
  • 录用日期:2022-11-10
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