译者:王小静校对:侯睿宏审核:许珂
Abstract:AIM:Todetermineriskfactorsforseverecardiovascular(CV)events(CVEs)inmalepatientswithcrystal-verifiedgout.SUBJECTSANDMETHODS:
malepatientswithcrystal-verifiedgoutwereprospectivelyfollowedupinto.Themeanfollow-upperiodwas6.9±2.0years.NewsevereCVEcasesanddeathswererecorded.LogisticregressionwasusedtoanalyzetheimpactoftraditionalandotherriskfactorsandallopurinoluseontheriskforsevereCVEs.RESULTS:32patientsdiedduringthefollow-upperiod.SevereCVEswererecordedin58(23.1%)patients;CVEdeathswerenotifiedin22(8.8%)patients.TheriskofallsevereCVEswashighforhypertension,increasedserumhigh-sensitivityC-reactiveprotein(hs-CRP)level(5mg/l),≥stageIIIchronickidneydisease(CKD)(glomerularfiltrationrate,60ml/min/1.73m2),alcoholintake(20g/day),coronaryheartdisease(CHD),andafamilyhistoryofprematureCHD.TheriskoffatalCVEswashighestforelevatedserumhs-CRPlevel,≥stageIIICKD,afamilyhistoryofprematureCHD,hypercholesterolemia,upperquartileofserumuricacidlevels(μmol/l),andregularintakeofallopurinol.CONCLUSION:InadditiontothetraditionalriskfactorsofCVcatastrophes,thepresenceofchronicinflammationandtheimpactofhighserumuricacidlevelsmayexplainthehighfrequencyofCVcatastrophes.
摘要:目的：探讨尿酸盐晶体证实的男性痛风患者发生严重心血管事件（CVEs）的危险因素。方法：对名体内存在尿酸盐结晶的男性痛风患者在年至年进行前瞻性随访,平均随访年限为6.9±2.0年,记录新的严重的CVEs病例和死亡情况。用Logistic回归分析传统和其它危险因素及别嘌醇的使用对严重CVE发生风险的影响。结果：32例患者在随访期内死亡,58例（23.1％）患者出现严重CVEs,其中22例（8.8％）患者死于CVE。所有严重CVEs发生的危险因素包括高血压、血清超敏C反应蛋白（hs-CRP）5mg/L、慢性肾脏疾病Ⅲ期（CKDⅢ）（即肾小球滤过率60ml/min/1.73m2）、酒精摄取量20g/天、冠心病（CHD）和早产儿有CHD家族史。血清hs-CRP水平显著升高、CKDIII期、早产儿有CHD家族史、高胆固醇血症、血清尿酸水平上升四分位（μmol/l）、常规摄入别嘌醇的患者发生致命性CVEs的风险最高。结论：除了传统心血管的危险因素外，慢性炎症及高血清尿酸水平也可能导致心血管不良事件发作频率升高。
引自:EliseevMS,DenisovIS,MarkelovaEI,etal.Independentriskfactorsforseverecardiovasculareventsinmalepatientswithgout:Resultsofa7-yearprospectivestudy[J].Terapevticheskiiarkhiv,,89(5):10.
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