| Objective To compare the difference between patients with AS without HU A and analyze the clinical characteristics of patients with ankylosing spondylitis(AS)with hyperuricemia(HUA),and to explore the correlation between the characteristics of HUA with AS and the distribution of TCM syndromes,and the pathogenesis of AS with HUA,to compare the differences between AS and health check-ups in terms of test indexes and complications,so as to provide ideas for clinical diagnosis and treatment.Method 1.In this a Cross-sectional study,consecutive patients were the AS patients who hospitalized in Rheumatology department of traditional Chinese Medicine of China-Japan Friendship Hospital from 2016-01-01 to 2018-09-30.According to the level of uric acid,AS with HUA was included in AS with HUA group,and others were included in AS with normal uric acid(UA)group.Match healthy examinees with 1:1.5ratio of age and sex,AS patients are included in AS group,and healthy examinees are included in health group;2.Record the basic data of patients and collect the results of blood routine,urine routine,liver and kidney function,blood lipid(total cholesterol,triglyceride,high density lipoprotein,low density lipoprotein),HLA-B27 typing,C-reactive protein,erythrocyte sedimentation rate(ESR),symptoms,signs,body mass index(BMI).According to Practical Rheumatology of Traditional Chinese Medicine and Guidelines for Diagnosis and Treatment of Common Diseases in Internal Medicine of Traditional Chinese Medicine issued by the Chinese Academy of Traditional Chinese Medicine,classify the syndrome types of AS:kidney deficiency and Du-meridian cold pattern/syndrome and kidney deficiency and damp heat pattern/syndrome.Collect the basic data of physical examinees in the same period,including name,sex,age,height,weight,BMI value,etc.Collect four test indicators of blood routine,urine routine,liver and kidney function and blood lipid;3.SPSS17.0 software was used for statistical analysis.Independent sample t test,non-parametric test,?2 test or Fisher's exact probability method were used to compare the differences between the two groups.Multivariate logistic regression was used to analyze the influencing factors of AS merging with HUA.The difference was statistically significant with P<0.05.4.This study has been approved by the Ethics Committee of China-Japan Friendship Hospital(Ethics Number:2018-16-K11)and registered in China Clinical Trials Registry(Registration Number:ChiCTR1800015565).Result 1.A total of 385 AS patients were enrolled,including 82 cases(21.3%)in hyperuricemia AS group,77 cases(93.9%)in males and 5 cases(6.1%)in females;303 cases(78.7%)in normal uric acid AS group,218 cases(71.95%)in males and 85 cases(28.05%)in females;295 cases(76.6%)in males and 90 cases(23.4%)in females,including 77 cases(93.9%)in hyperuricemia AS group and 5 cases(6.1%)in females;and 218 males(71.95%)and 85 females(18.05%)in normal uric acid AS group.The ratio of male to female was 3.28:1.In this study,the prevalence of HUA was 21.3%in AS patients,26.1%in males and 5.56%in females.There were significant differences in gender,age,BMI,WBC,RBC,HGB,urinary PH,creatinine,total cholesterol,triglyceride,high density lipoprotein,low density lipoprotein,TCM syndrome classification and complications(dyslipidemia,hypertension,gout,fatty liver)between the two groups(P<0.05).There were no significant differences in the course of diagnosis,ESR,CRP,sacroiliac joint classification,and complications(coronary heart disease,diabetes mellitus,ocular involvement),etc.(P>0.05).In addition,there were 364 valid HLA-B27 gene detection data in this study,among which 323 cases were positive(68 cases in hyperuricemia AS group,255 cases in normal AS group),41 cases were negative(9 cases in hyperuricemia AS group,32 cases in normal AS group),the total positive rate was 88.7%.There was no difference in the positive rate of HLA-B27 gene between the two groups(P>0.05).Among 323 HLA-B27 positive patients,157 cases had valid data of HLA-B27 genotype,including 2 cases of type 02(1 case in hyperuricemia AS group,1 case in normal uric acid AS group),93 cases of type 04(18 cases in hyperuricemia AS group,75 cases in normal uric acid AS group),62 cases of type 05(9 cases in hyperuricemia AS group and 53 cases in normal uric acid AS group).There was no difference in genotyping between the two groups(P>0.05).Multiple logistic regression analysis showed that age[p=-0.051,OR=0.951,95%CI(0.919,0.984)],BMI[?=0.207,OR=1.230,95%CI(1.127,1.342)],creatinine[?=0.041,OR=1.042,95%CI(1.018,1.067)],fatty liver[?=1.151,OR=3.162,95%CI(1.596,6.266)]are the influencing factors of AS patients with HUA(P<0.05).2.A total of 589 health examinees matched with age and sex of AS patients were included,450 males(76.4%)and 139 females(23.6%).The ratio of males to females was 3.24:1.The average age of AS group was 34.80±10.47 years,and that of healthy group was 35.03±10.39 years(P>0.05).The baseline of age and sex was the same between the two groups.There was no significant difference in BMI,urinary PH,blood sugar and LDL between AS group and healthy group(P>0.05);WBC,PLT,urinary specific gravity,LDL/HDL in AS group were higher than those in healthy group;RBC,HGB,total bilirubin,creatinine,uric acid,CHO,TG and HDL were lower than those in healthy group.There was no difference in the prevalence of HUA and the sex distribution of HUA between AS group and healthy group(P>0.05).The majority of patients with HUA in both groups were males;the proportion of patients with AS group complicated with low-density lipoproteinemia was higher than that in healthy group(61%vs.21.9%,P<0.05);the proportion of patients with AS group complicated with anemia was higher than that in healthy group(13.8%vs.2.2%),with mild anemia as the main cause;The proportion of PLT elevation in the combined group was higher than that in the healthy group(14.6%vs.4.1%).conclusion 1.Ankylosing spondylitis patients with hyperuricemia are mostly male,and the onset age is young.There are metabolic syndrome tendencies such as increased BMI and dyslipidemia.The proportion of patients with dyslipidemia,fatty liver,hypertension and gout is higher than that of patients with ankylosing spondylitis without hyperuricemia.Ankylosing spondylitis with low high density lipoproteinemia,elevated platelet count,anemia and C health check-up were more common,and the ratio of LDL to HDL was higher,the average level of PLT was higher.2.The syndrome of AS patients with HUA is mainly kidney deficiency and damp heat pattern/syndrome,and the treatment should focus on tonifying the kidney,clear heat,remove dampness and turbidity.3.Age,BMI,creatinine and fatty liver are risk factors for AS patients with HUA.4.The proportion of WBC,PLT and urine in AS patients was higher than that in healthy persons.RBC,HGB,uric acid,CHO,TG and HDL were lower than those in healthy persons.5.There is no statistical difference in the incidence of hyperuricemia between ankylosing spondylitis and healthy people,but ankylosing spondylitis with hyperuricemia has its unique TCM syndrome characteristics and clinical characteristics. |
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