原发性高血压儿童血尿酸水平与心脏亚临床损伤的相关性

Association between serum uric acid and subclinical cardiac damage in children with primary hypertension

摘要:

目的 评估原发性高血压儿童的心脏亚临床损害情况，并分析血尿酸水平与心脏亚临床损害的相关性。方法 回顾性分析2015年1月至2020年6月于苏州大学附属儿童医院心血管内科住院的55例原发性高血压患儿治疗前的临床资料，并选取该院同期同年龄、同性别的45例健康体检儿童作为对照组。分析两组儿童临床特征、实验室检查、左心结构、收缩和舒张功能指标的差异，并探讨高血压患儿血尿酸水平与其左心结构、收缩和舒张功能指标的相关性。结果 高血压组左心室质量、左心室质量指数及相对室壁厚度显著高于对照组（P < 0.05），并有20例（36%）出现左心室肥厚。高血压组左心房内径和主动脉根部内径也显著高于对照组（P < 0.05）。高血压组二尖瓣口舒张早期峰值流速/二尖瓣环舒张早期速度的比值显著高于对照组（P < 0.05）。相关分析显示，血尿酸水平与原发性高血压患儿左心室质量（r=0.534，P < 0.01）、左心房内径（r=0.459，P < 0.01）、主动脉根部内径（r=0.361，P=0.010）呈正相关；校正血压影响后血尿酸水平仍与上述指标呈正相关（P < 0.05）。结论 原发性高血压患儿可出现左心室肥厚、舒张功能受损、左心房及主动脉近端扩张等亚临床损害。血尿酸水平增加与原发性高血压患儿心脏损害显著相关。

Abstract:

Objective To evaluate the condition of subclinical cardiac damage in children with primary hypertension and the association between serum uric acid and subclinical cardiac damage.Methods A retrospective analysis was performed on the medical data of 55 children who were hospitalized and diagnosed with primary hypertension in the Department of Cardiology,Children's Hospital of Soochow University from January 2015 to June 2020.Forty-five healthy children,matched for age and sex,were enrolled as the control group.The two groups were compared in terms of clinical features,laboratory examination,and parameters for left ventricular structure,systolic function,and diastolic function.The correlation of serum uric acid with the parameters for left ventricular structure,systolic function,and diastolic function in children with primary hypertension was analyzed.Results Compared with the control group,the hypertension group had significantly higher left ventricular mass(LVM),left ventricular mass index(LVMI),and relative wall thickness(RWT)(P<0.05).Among the children with primary hypertension,20(36%)had left ventricular hypertrophy.The hypertension group had significantly larger left atrial diameter and aortic root diameter than the control group(P<0.05).The hypertension group had a significantly higher ratio of early diastolic mitral inflow velocity to early diastolic mitral annular velocity than the control group(P<0.05).The correlation analysis showed that in children with primary hypertension,serum uric acid was positively correlated with LVM(r=0.534,P<0.01),left atrial diameter(r=0.459,P<0.01),and aortic root diameter(r=0.361,P=0.010).After adjustment for blood pressure,serum uric acid was still positively correlated with the above parameters(P<0.05).Conclusions Children with primary hypertension may have subclinical cardiac damage such as left ventricular hypertrophy,left ventricular diastolic dysfunction,left atrial enlargement,and proximal aortic dilation.Elevated serum uric acid is significantly associated with cardiac damage in children with primary hypertension.