痛風患者血尿酸和炎性因子水平變化及相關性分析

查旭雯 夏光云

摘要：目的? 探討痛風患者血尿酸水平以及炎性因子C反應蛋白（CRP）、白細胞介素-6（IL-6）、腫瘤壞死因子-α（TNF-α）水平的變化，并對其進行相關性分析。方法? 選擇2018年5月～2019年2月我院收治的52例痛風患者作為患者組，選取同期52名健康受試者作為對照組。檢測兩組受試者的血尿酸及CRP、IL-6、TNF-α的水平;采用Pearson相關分析評估血尿酸與炎性因子水平的相關性;采用ROC曲線法評估CRP、IL-6、TNF-α聯合血尿酸對痛風診斷的曲線下方面積（AUC）、靈敏度和特異性。結果? 患者組血尿酸、CRP、IL-6、TNF-α水平均高于對照組，差異具有統計學意義（P<0.05）。血尿酸與CRP（r=0.193，P=0.050）、IL-6（r=0.225，P=0.021）、TNF-α（r=0.342，P=0.000）的水平均呈正相關關系。CRP、IL-6、TNF-α聯合血尿酸水平診斷痛風的AUC面積分別為0.824（靈敏度為86.30%，特異性為67.30%）、0.811（靈敏度為80.40%，特異性為73.10%）、0.989（靈敏度為100.00%，特異性為96.20%）。結論? 痛風患者升高的血尿酸水平可能與循環中的炎性因子密切相關，且炎性因子的水平對于痛風的診斷具有一定的指導意義。

關鍵詞：痛風;尿酸;炎性因子;診斷

中圖分類號：R589.7? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? 文獻標識碼：A? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? DOI：10.3969/j.issn.1006-1959.2019.15.058

文章編號：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.

綜上所述，痛風患者升高的血尿酸水平可能與循環中的炎性因子存在聯系，且炎性因子的水平對于痛風的診斷具有一定的指導意義。

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收稿日期：2019-3-19;修回日期：2019-3-29

編輯/楊倩