目的 探讨H型高血压患者血尿酸（serum uric acid，SUA）水平与非酒精性脂肪性肝病（non-alcoholic fatty liver disease，NAFLD）的关系。 方法 回顾性研究，收集2022—2023年在延安大学咸阳医院心血管内科住院的H型高血压患者共284例，根据是否患有NAFLD，分为合并NAFLD组88例和正常组196例。比较两组患者一般资料及实验室指标，采用多因素logistic回归分析H型高血压患者发生NAFLD的影响因素，进一步绘制ROC曲线观察SUA预测NAFLD的作用，并根据约登指数最大值选取最佳截断值。 结果 合并NAFLD组患者BMI、收缩压（systolic blood pressure， SBP）、舒张压（diastolic blood pressure，DBP）、总胆固醇（total cholesterol，TC）、甘油三酯（triglycerides，TG）、低密度脂蛋白胆固醇（low-density lipoprotein cholesterol， LDL-C）、SUA、γ-谷氨酰转肽酶（γ- Glutamyl transpeptidase，γ-GT）及谷丙转氨酶（alanine aminotransferase， ALT）水平均高于正常组，而年龄、高密度脂蛋白胆固醇（high-density lipoprotein cholesterol，HDL-C）低于正常组（P < 0.05）。多因素logistic回归分析结果显示，BMI（OR= 1.173，95%CI：1.066 ~ 1.291）、UA（OR= 1.005，95%CI：1.001 ~ 1.010）、TG（OR= 1.929，95%CI：1.042 ~ 3.574）水平升高是H型高血压患者发生NAFLD的危险因素（P < 0.05）。ROC曲线示SUA、TG、BMI及三者联合的曲线下面积（AUC）分别为0.709、0.707、0.750、0.796。 结论 发生NAFLD的H型高血压患者BMI及SUA、TG水平均较无脂肪肝组患者高，SUA水平升高是H型高血压患者发生NAFLD的危险因素，且SUA水平超过337 μmol/L对预测NAFLD有重要价值。

Objective To explore the relationship between blood uric acid levels and non-alcoholic fatty liver disease in patients with type H hypertension. Methods The clinical data of 284 patients with type H hypertension admitted to the Cardiovascular Department， Xianyang Hospital， Yan'an University in 2022 were collected and retrospectively reviewed. The patients were divided into NAFLD group （n = 88）and normal group （n = 196） according to whether they had NAFLD. The general information and laboratory indicators were compared between the two groups. Multivariate logistic regression analysis was conducted to explore the influencing factors of NAFLD in H-type hypertension patients. The draw ROC curves were plotted to observe the role of SUA in predicting NAFLD and select the optimal cutoff value based on the maximum Youden index. Results The NAFLD group demonstrated higher levels in body mass index， systolic blood pressure， diastolic blood pressure， total cholesterol， triglycerides， low-density lipoprotein cholesterol， SUA， γ-Glutamyl transpeptidase and alanine aminotransferase compared to the normal group， but significantly lower levels at age and high-density lipoprotein cholesterol（P < 0.05）. The multivariate logistic regression analysis showed that elevated levels of BMI（OR= 1.173，95%CI：1.066 ~ 1.291）， SUA（OR= 1.005，95%CI：1.001 ~ 1.010）， and TG（OR= 1.929，95%CI：1.042 ~ 3.574）were risk factors for NAFLD in patients with type H hypertension （P < 0.05）. The ROC curves showed that the area under the curve （AUC） of SUA， TG， BMI， and their combination were 0.709， 0.707， 0.750， and 0.796， respectively. Conclusion type H hypertensive NAFLD patients have high levels of BMI， SUA， TG compared to non-NAFLD patients. Elevated SUA is a risk factor for type H hypertensive NAFLD patients， with SUA > 337 μmol/L as a significant value for predicting NAFLD.