【摘要】 目的 分析痛风性关节炎患者发生尿酸盐结晶的危险因素，探讨双能量CT成像对尿酸盐结晶检测的价值。方法 回顾分析2017年3月-2019年3月我院收治的112例痛风性关节炎患者的临床资料，依据双能CT成像是否检出尿酸盐结晶分为尿酸盐结晶组和非尿酸盐结晶组，采用单因素和多因素Logistic回归分析发生尿酸盐结晶的危险因素。结果 112例患者尿酸盐结晶组30例，非尿酸盐结晶组82例；两组年龄、糖尿病、BMI、总胆红素、血糖、高尿酸水平比较，差异有统计学意义（P<0.05）；两组性别、身高、体重、高血压、高血脂、肌酐、血尿素氮、三酰甘油、总胆固醇水平比较，差异无统计学意义（P>0.05）；多因素Logistic回归分析显示，年龄（OR=6.593,95%CI:0.125～0.791）、总胆红素（OR=2.283,95%CI:0.947～5.506）、血糖（OR=4.168,95%CI:1.666～10.428）、高尿酸水平（OR=4.168,95%CI:1.601～10.121）是痛风性关节炎患者发生尿酸盐结晶的独立危险因素（P<0.05）。结论 痛风性关节炎患者的尿酸盐结晶发生率较高，年龄、总胆红素、血糖以及血尿酸水平是痛风性关节炎患者发生尿酸盐结晶的独立危险因素，双能量CT扫描成像通过后处理将尿酸盐结晶以绿色伪彩形式清楚显示，有重大诊断价值。更多还原

【Abstract】 Objective To analyze the risk factors of urate crystallization in patients with gouty arthritis, and to explore the value of dual-energy CT imaging in the detection of urate crystallization.Method The clinical data of 112 patients with gouty arthritis admitted to our hospital from March 2017to March 2019 were retrospectively analyzed. According to whether urate crystals were detected by dual-energy CT imaging, they were divided into urate crystals group and non-urate crystals group. Univariate and multivariate logistic regression analysis was used to analyze the risk factors of urate crystals.Results Among 112 patients, 30 patients in urate crystallization group and 82 patients in non-urate crystallization group. There were significant differences in age, diabetes, BMI, total bilirubin, blood glucose and hyperuricemia between the two groups(P<0.05). There was no significant difference in gender, height, weight, hypertension, hyperlipidemia, creatinine, blood urea nitrogen, triglyceride and total cholesterol between the two groups( P>0.05). Multivariate Logistic regression analysis showed that age(OR=6.593, 95%CI: 0.125-0.791), total bilirubin(OR=2.283, 95%CI: 0.947-5.506), blood glucose(OR=4.168, 95%CI: 1.666-10.428) and high uric acid level(OR=4.168, 95%CI: 1.601-10.121) were independent risk factors for uric acid crystallization in patients with gouty arthritis(P<0.05).Conclusion The incidence of urate crystallization in patients with gouty arthritis is higher; age,total bilirubin, blood glucose and serum uric acid levels are independent risk factors for urate crystals in patients with gouty arthritis. Dual-energy CT scanning imaging clearly shows urate crystals in the form of green pseudo-color through post-processing, which has great diagnostic value.更多还原