减重手术对术后早期血清尿酸水平的影响

Impact of Bariatric Surgery on Early Postoperative Serum Uric Acid Levels

摘要: 背景：研究肥胖患者在肥胖手术后早期血清尿酸(SUA)浓度的变化，并明确导致术后早期SUA浓度改变的影响因素。方法：共计纳入50例患者。在基线和每个随访点收集术前和术后观测指标。符合正态分布的测量数据用平均 ± 标准差表示，采用配对t检验计算随访点与基线之间的配对差异。非正态分布以中位数(四分位数间距)表示，两组间比较采用Wilcoxon秩和检验。采用单因素线性回归分析，探讨影响SUA变化幅度的独立因素。结果：术后1个月SUA水平显著升高(P < 0.05)，其升高与患者基线尿素氮水平呈正相关(r = 0.280, P < 0.05)。ALT、AST在1个月时显著上升(P < 0.05)。Cr、BUN、HDL、LDL、总胆固醇、甘油三酯、血糖、白细胞、中性粒细胞、CRP在术后1个月显著下降(P < 0.05)。单因素回归分析显示，血尿素氮(β = 0.28, P < 0.05)为术后SUA浓度改变的危险因素。结论：减重手术患者的SUA水平在术后第一个月内升高，然后在随访期间逐渐下降。减重患者术后1个月肌酐、尿素氮水平下降，相关性研究分析提示术后1个月SUA浓度的变化与基线BUN水平相关。BUN是术后1个月SUA变化的影响因素之一。

Abstract: Objectives: To research the alterations in early postoperative SUA concentrations in individuals with obesity and determine the risk factors for alterations during the early postoperative period. Methods: Fifty patients were enrolled. Pre- and post-operative variables were collected at baseline and at each follow-up point. Measurements meeting a normal distribution were expressed as the mean ± standard deviation, and paired differences between follow-up points and baseline were calculated using a paired t-test. Non-normal distribution is presented as median (interquartile spacing) and Wilcoxon rank sum test. Univariate linear regression analyses were performed to ex-plore independent factors that influenced the magnitudes of SUA change. Results: SUA levels were significantly increased 1 month after baseline (P < 0.05), which was positively correlated with pa-tient baseline BUN (r = 0.280, P < 0.05). ALT and AST increased significantly at 1 month (P < 0.05). Cr, BUN, HDL, LDL, total cholesterol, triglycerides, blood glucose, leukocytes, neutrophils, and CRP decreased significantly at 1 month after surgery (P < 0.05). Univariate regression analysis showed that blood urea nitrogen (β = 0.28, P < 0.05) was a risk factor for the postoperative SUA concentra-tion change. Conclusions: A significant increase in SUA levels within 1 month after surgery. SUA lev-els increased in reduced surgery patients within the first postoperative month and then gradually decreased during the follow-up period. Patients with obesity had decreased creatinine and BUN levels 1 month after surgery, and the analysis of correlation studies suggested that the change in SUA concentration 1 month after surgery was correlated with baseline BUN levels. BUN is one of the factors affecting the SUA change at 1 month after surgery.