[1]渠井泉,祝 洁,李 青△,等.上海远郊某镇老年人群高尿酸症患病率及影响因素调查研究*[J].陕西医学杂志,2020,49(3):375-377，封3.
　QU Jingquan,ZHU Jie,LI Qing..Prevalence and risk factors of hyperuricemia among the elderly in the outskirts of Shanghai[J].,2020,49(3):375-377，封3.
点击复制

上海远郊某镇老年人群高尿酸症患病率及影响因素调查研究*
分享到：

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
49
期数:
2020年3期
页码:
375-377，封3
栏目:
调查研究
出版日期:
2020-03-05

文章信息/Info

Title:
Prevalence and risk factors of hyperuricemia among the elderly in the outskirts of Shanghai
文章编号:
DOI:〖HT5K〗10.3969/j.issn.10007377.2020.03.028
作者:
渠井泉1;  祝 洁2;  李 青3△; 张进安2; 张 菁2△
1.上海市金山区山阳镇社区卫生服务中心(上海 201508); 2.上海健康医学院附属周浦医院内分泌-风湿科(上海 201318); 3.新疆医科大学厚博学院医学系检验技术专业2016级( 乌鲁木齐 834000)
Author(s):
QU Jingquan; ZHU Jie; LI Qing.
Shanyang Community Health Service Center,Jinshan District,Shanghai(Shanghai 201508)
关键词:
高尿酸血症;  患病率;  影响因素;  老年人;  上海
Keywords:
Hyperuricemia;  Prevalence;  Risk factors;  The elderly;  Shangha
分类号:
R589.2
文献标志码:
A
摘要:
目的:调查上海远郊社区老年人高尿酸血症患病率及危险因素,为高尿酸血症的预防提供依据。方法:以2018年3～9月在上海某社区参加体检的60岁以上老年人为研究对象,其中男性1813例,女性2598例,体检内容包括身高、体重、腰围、尿酸、血压、血糖、血脂、糖化血红蛋白等指标。应用SPSS 21.0软件包进行统计学分析,计数资料以百分比(%)表示,观察其患病率并采用单因素和多因素Logistic回归分析其危险因素。结果:HUA的患病率16.25%,其中男性患病率28.90%,女性患病率7.43%,各年龄阶段,男性高尿酸血症患病率均高于女性(P<0.05),男女HUA患病率均随年龄增长而增长。单因素非条件Logistic回归分析显示性别、年龄、甘油三酯、低密度脂蛋白、高血压、高体质指数(超重)是高尿酸血症的相关联因素,多因素非条件Logistic回归分析表明,性别、年龄、甘油三酯、低密度脂蛋白、高血压、高体质指数(超重)是高尿酸血症的危险因素。结论:上海市某镇高尿酸血症的患病率较高,高尿酸血症的发生与性别、年龄、甘油三酯、低密度脂蛋白、高血压、高体质指数(超重)有关,应警惕这些危险因素,提前做好防范措施。
Abstract:
Objective:To investigate the prevalence and risk factors of hyperuricemia among the elderly in the outskirts of Shanghai,and to provide evidence for the prevention of hyperuricemia.Methods:From March to September 2018,the elderly over 60 years who participated in the medical examination in our community were studied,including 1813 men and 2598 women.The medical examination contents included height,weight,the waist,uric acid,blood pressure,blood sugar,blood lipid,glycosylated hemoglobin and other indicators.Using SPSS 21.0 software package for statistical analysis,counting data was expressed as percentage(%).The prevalence was observed and risk factors were analyzed by univariate and multivariate Logistic regression.Results:The prevalence of hyperuricemia was 16.25%,of which the prevalence rate of was 28.90% for men and 7.43% for women.At all ages,the prevalence rate of hyperuricemia in men was higher than that in women(P<0.05),and the prevalence of hyperuricemia increased with age for both men and women.The univariate non-conditional Logistic regression analysis showed that gender,age,triglyceride,low-density lipoprotein,hypertension,and high body mass index(overweight)were associated factors of hyperuricemia,and the multivariate non-conditional Logistic regression analysis showed that gender,age,triglycerides,low-density lipoproteins,hypertension,and high body mass index(overweight)were risk factors for hyperuricemia.Conclusion:The prevalence of hyperuricemia is high in Shanyang town of Shanghai.The occurrence of hyperuricemia is related to gender,age,triglyceride,low-density lipoprotein,hypertension,and high body mass index(overweight).These risk factors should be guarded against.

参考文献/References:

[1] Multidisciplinary Expert Task Force onHyperuricemia and Related Diseases.Chinese multidisciplinary expert consensus on the diagnosis and treatment of hyperuricemia and related diseases [J].Chin Med J(Engl),2017,130(20):2473-2488.
[2] 郭立新.从《高尿酸血症和痛风治疗中国专家共识》谈高尿酸血症的治疗[J].药物与临床,2014,11(1):21.
[3] 中华医学会糖尿病分会.中国2型糖尿病防治指南[J].中华糖尿病杂志,2014,6(7):448.
[4] Wu J,Qiu L,Cheng XQ,et al.Hyperuricemia and clustering of cardiovascular risk factors in the Chinese adult population[J].Sci Rep,2017,7(1):5456.
[5] 梁 晶,吴鑫雨,宋 伟,等.广州花都区健康体检人群中高尿酸血症的调查研究[J].新医学,2016,47(3):155.
[6] 贾 西,张进安.痛风治疗新理念--EULAR2016痛风诊治指南的更新和解读[J].上海医药,2018,39(2):3.
[7] 丁 宁.上海某社区老年人血尿酸水平及其影响因素分析[J].上海医药,2018,39(10):42.
[8] 李 岩,孙景波.社区老年人高尿酸血症患病率及危险因素调查研究[J].重庆医学,2017,46(12):1666-1667.
[9] 卢逸烨,余佩毅,宋 锐,等.上海某社区老年人血尿酸发病率调查及影响因素分析[J].上海医药,2015,36(22):40.
[10] Sharaf EL,Din UAA,Salem MM,et al.Uric acid in the pathogenesis of metabolic,renal,and cardiovascular diseases:A review[J].J Adv Res,2017,8(5):537-548.
[11] 吕 赛,周玉杰,刘 巍.高尿酸血症、代谢综合征与冠心病的研究进展[J].心肺血管病杂志,2018,37(1):76-77.
[12] 屈炯堂,刘本坚,梁美玲.老年退休人员高尿酸血症的患病率及影响因素分析[J].中华老年心脑血管病杂志,2013,15(11):1145.
[13] 韦 宇.高尿酸血症与心血管病危险因素的关系[J].心血管病防治知识,2015,10:54.
[14] Zhang Y,Wei F,Chen C,et al.Higher triglyceride level predicts hyperuricemia:A prospective study of 6-year follow-up[J].J Clin Lipidol,2018,12(1):185-192.
[15] 刘 英,曾 勇.高尿酸血症与肥胖[J].中国心血管杂志,2016,21(1):11.(收稿:2019-08-14)超声造影模型构建对乳腺超声BI-RADS分类诊断中的应用唐 燕,宋建琼,魏国李四川省达州市中心医院功能科(达州635000) 摘 要 目的:探讨超声造影模型构建对乳腺超声BI-RADS分类诊断中的应用价值。方法:收集行超声造影检查乳腺肿物BI-RADS 4-5类患者147例,构建造影模型并以BI-RADS 4A作为阈值计算诊断效能,比较检查前后乳腺肿物活检率、恶性病变确诊率及远期恶性病变发生率。结果:超声造影模型以BI-RADS 3-4C类作为阈值建立ROC曲线,显示AUC面积BI‐RADS 3 类、BI‐RADS 4A 类、BI‐RADS 4B 类及BI‐RADS 4C 类分别为0.702,0.845,0.856,0.770。超声造影模型构建后诊断结果调整,以BI‐RADS 4A 类作为阈值进行良恶性判定,诊断灵敏度、特异度、准确度、阳性预测值、阴性预测值及YI分别为93.35%,75.62%,82.82%,76.67%,93.11%,0.69; 全部病灶均接受穿刺活检,活检率为100%(156/156),恶性病变确诊率为 44.23%(69/156); 分别以BI‐RADS 3 类和4A类作为活检阈值,恶性病变确诊率分别为57.05%(89/156),74.36%(116/156); 活检率分别为57.69%(90/156),55.77%(87/156); 远期恶性病变发生率分别为0.64%(1/156),3.21%(5/156)。结论:超声造影模型构建用于乳腺超声BI-RADS分类诊断可有效降低患者活检比例,提高乳腺癌确诊率,且未导致远期癌变风险上升,对于改善超声BI‐RADS分类诊断效能和预防不合理活检发生具有重要意义。关键词 乳腺疾病; 恶性肿瘤; 超声; 造影模型; BI-RADS; 诊断中图分类号:R 文献标识码:A DOI:10.3969/j.issn.1000-7377.2020.03.00Application of contrast-enhanced ultrasound model construction in classification diagnosis of breast ultrasound BI-RADSTANG Yan,SONG Jianqiong,WEI Guoli.Functional Department of Dazhou Central Hospital,Sichuan Province(Dazhou 635000)Abstract Objective:To investigate the application value of contrast-enhanced ultrasound model construction in classification diagnosis of breast ultrasound BI-RADS.Methods:Clinical data of 147 patients with BI-RADS 4-5 type by contrast-enhanced ultrasound were retrospectively collected in the period from January 2016 to March 2019 and the diagnostic efficiency were calculated by establishing contrast model and using BI-RADS 4A as threshold value.The biopsy rate of breast tumors,the detection rate of malignant lesions and the incidence of malignant lesions with follow-up were compared before and after contrast-enhanced ultrasonography.Results:Contrast-enhanced ultrasound models used BI-RADS 3-4C as threshold to establish ROC curves.The results showed that AUC area of BI-RADS 3,BI-RADS 4A,BI-RADS 4B and BI-RADS 4C were 0.702,0.845,0.856 and 0.770,respectively.After establishment of contrast-enhanced ultrasound model,the diagnostic results were adjusted and BI-RADS 4A was used as threshold for benign and malignant judgment.The diagnostic sensitivity,specificity,accuracy,positive predictive value,negative predictive value and Yoden index were 93.35%,75.62%,82.82%,76.67%,93.11% and 0.69,respectively.All lesions underwent puncture biopsy and the biopsy rate were 100%(156/156),and the diagnostic rate of malignant lesions was 44.23%(69/156).BI-RADS 3 and 4A were used as biopsy thresholds respectively and the diagnostic rates of malignant lesions were respectively 57.05%(89/156)and 74.36%(116/156); the biopsy rate were respectively 57.69%(90/156)and 55.77%(87/156); the malignant lesions for long-term were respectively 0.64%(1/156)and 3.21%(5/156).Conclusion:Contrast-enhanced ultrasound model for breast BI-RADS classification diagnosis can effectively reduce the proportion of biopsy,improve the diagnostic rate of breast cancer and does not cause the increased risk of long-term canceration.It should be great significance to improve the diagnostic efficiency of BI-RADS classification and prevent the occurrence of unreasonable biopsy.Key words Breast diseases; Malignant tumors; Ultrasound; Contrast-enhanced model; BI-RADS; Diagnosis参考文献[1] 季 宇,李 丽,候小霞.彩色多普勒超声在乳腺肿物良恶性鉴别诊断和乳腺癌分期中的临床研究[J].陕西医学杂志,2017,46(12):1702-1703.
[2] Dabbous F,Dolecek TA,Friedewald SM,et al.Performance characteristics of digital vs film screen mammography in community practice [J].Breast J,2018,24(3):369-372.
[3] Cheung YC,Juan YH,Lin YC,et al.Dual-Energy Contrast-Enhanced Spectral Mammography:Enhancement Analysis on BI-RADS 4 Non-MassMicrocalcifications in Screened Women:[J].Plos One,2016,11(9):e0162740.
[4] 罗 俊,陈吉东,陈 琴,等.乳腺良恶性病灶超声造影预测模型在乳腺影像报告与数据系统4 类乳腺病灶恶性风险评估中的应用价值[J/CD].中华医学超声杂志(电子版),2016,13(6):459‐465.
[5] 中国抗癌协会乳腺癌专业委员会.中国抗癌协会乳腺癌诊治指南与规范(2017年版)[J].中国癌症杂志,2017,25(9):692-752.
[6] 杜燕然,陈 曼,唐 蕾,等.乳腺小肿块BI‐RADS 及超声弹性成像的临床研究[J].中国超声医学杂志,2016,32(1):22‐25.
[7] Wilczek B,Wilczek HE,Rasouliyan L,et al.Adding 3D automated breast ultrasound to mammography screening in women with heterogeneously and extremely dense breasts:Report from a hospital-based,high-volume,single-center breast cancer screening program [J].Eur J Radiol,2016,85(9):1554-1563.
[8] Elezaby M,Li G,Bhargavan-Chatfield M,et al.ACR BI-RADS Assessment Category 4 Subdivisions in Diagnostic Mammography:Utilization and Outcomes in the National Mammography Database [J].Radiology,2018,287(2):770-775.
[9] Huzarski T,Górecka-Szyld B,Huzarska J,et al.Screening with magnetic resonance imaging,mammography and ultrasound in women at average and intermediate risk of breast cancer [J].Hered Cancer Clin Pract,2017,15(4):4-12.
[10] Salazar AJ,Romero JA,Bernal OA,et al.Reliability of the BI-RADS Final Assessment Categories and Management Recommendations in aTelemammography Context [J].J Am Coll Radiol,2017,14(5):686-692.
[11] Ma X,Liu R,Zhu C,et al.Diagnostic Value of Contrast-EnhancedSonography for Differentiation of Breast Lesions:A Meta-analysis [J].J Ultrasound Med,2016,35(10):2095-2102.
[12] Shimazu K,Ito T,Uji K,et al.Identification of sentinel lymph nodes by contrast‐enhanced ultrasonography with Sonazoid in patients with breast cancer:a feasibility study in three hospitals [J].Cancer Med,2017,6(8):1915-1922.
[13] Yaffe MJ,Jong RA.Adjunctive ultrasonography in breast cancer screening [J].Lancet,2016,387(10016):313-314.
[14] Durand MA,Hooley RJ.Implementation of Whole-Breast ScreeningUltrasonography [J].Radiol Clin N Am,2017,55(3):527-539.
[15] Mishima M,Toh U,Iwakuma N,et al.Evaluation of contrast Sonazoid-enhanced ultrasonography for the detection of hepatic metastases in breast cancer [J].Breast Cancer,2016,23(2):231-241.
[16] Amioka A,Masumoto N,Gouda N,et al.Ability of contrast-enhanced ultrasonography to determine clinical responses of breast cancer to neoadjuvant chemotherapy [J].Jpn J Clin Oncol,2016,46(4):303-309.

相似文献/References:

[1]赵冰,蒋风萍.北京某高校教师高尿酸血症与代谢综合征各组分相关性分析[J].陕西医学杂志,2016,(10):1430.
[2]陈玉菲,杨 萍.高龄老年住院原发性高血压合并高尿酸血症发病情况及相关因素分析[J].陕西医学杂志,2019,(6):725.
[3]张静雯,汪 宁,邱红霞,等.非布司他治疗早期糖尿病肾病合并高尿酸血症疗效及对患者肾功能影响研究*[J].陕西医学杂志,2020,49(2):209.
　ZHANG Jingwen,WANG Ning,QIU Hongxia,et al.Efficacy of febuxostat on early diabetic nephropathy with hyperuricemia and its effect on renal function[J].,2020,49(3):209.
[4]许家顺,马世平,温有锋△.西藏藏族人群牙列缺损及修复情况调查研究*[J].陕西医学杂志,2020,49(5):635.
　XU Jiashun,MA Shiping,WEN Youfeng..The investigation of dentition defect and restoration in Tibetan population in Tibet[J].,2020,49(3):635.
[5]刘玲娇,余湘尤,虢小丽.西安市职业人群非酒精性脂肪性肝病患病率及其危险因素调查研究[J].陕西医学杂志,2021,50(1):107.[doi:DOI:10.3969/j.issn.1000-7377.2021.01.029]
　LIU Lingjiao,YU Xiangyou,GUO Xiaoli.Prevalence and risk factors of nonalcoholic fatty liver disease among occupational population in Xi'an[J].,2021,50(3):107.[doi:DOI:10.3969/j.issn.1000-7377.2021.01.029]
[6]李芝帆,王君兰,张 健,等.陕西省商州区2215例0～6岁儿童缺铁性贫血患病现状调查及影响因素分析[J].陕西医学杂志,2021,50(8):1027.[doi:DOI:10.3969/j.issn.1000-7377.2021.08.031]
　LI Zhifan,WANG Junlan,ZHANG Jian,et al.Investigation and analysis of IDA in 2215 children aged 0～6 years in Shangzhou District,Shaanxi Province[J].,2021,50(3):1027.[doi:DOI:10.3969/j.issn.1000-7377.2021.08.031]
[7]孙黎明,夏晓露,马红萍.高尿酸血症与高血压及心血管疾病关系研究进展[J].陕西医学杂志,2024,(2):286.[doi:DOI:10.3969/j.issn.1000-7377.2024.02.031]

备注/Memo

备注/Memo:
*上海市浦东新区卫生和计划生育委员会学科建设特色专病-糖尿病基金资助项目(PWZZB2017-25)；上海健康医学院种子基金资助项目(SFP-18-21-17-003)
更新日期/Last Update: 2020-03-25