高尿酸血症与冠脉造影确诊的冠心病的相关性

The Relation of Hyperuricemia and Angiographic Coronary Artery Disease

目的：探讨高尿酸血症（HUA）与冠脉造影确诊的冠心病（CAD）的发生及严重程度的相关性。方法：对647例接受冠脉造影的患者测定各项临床指标,根据冠脉造影结果分为CAD组和对照组,以发生病变的血管支数及Gen？sini积分反映冠心病严重程度,分性别进行对照研究。结果：（1）女性CAD组的HUA比例高于对照组（P=0.012）。（2）HUA仅在女性是冠心病发生的影响因素（OR=2.022,95%CI：1.098-3.723,P=0.023）,但在对年龄进行调整后,HUA亦未入选冠心病影响因素（OR=1.513,95%CI：0.778-2.931,P=0.221）。两性患有HUA都不是冠心病发生的独立危险因素。（3）女性病变血管支数的分布在HUA组与非HUA组之间差异有统计学意义（Z=2.51,P=0.01）。女性HUA患者的Gensini积分高于非HUA患者（P=0.04）,且在女性的全组、HUA组及非HUA组Gensini积分与血尿酸水平均呈正相关（rs分别为0.181、0.291和0.138,P〈0.05或P〈0.01）。结论：女性HUA与冠心病的发生有一定关联,但不是独立危险因素。临床诊断中似应重视高龄女性HUA患者发生冠心病的危险。

Objective： To evaluate the association between hyperuricemia （HUA） and the presence and severity of angiographic coronary artery disease （CAD）. Methods： According to the results of angiography, 647 patients were divided into CAD group and control group. The severity of CAD was measured in terms of the number of vessels with disease and Gensini score. Results： （1） In women, the HUA percentage was significantly higher in CAD group than that in control group （P 0.01）. （2） HUA was significantly associated with the presence of CAD only in women （OR = 2.022,95%CI： 1.098-3.723,P 0.05）. However, after adjusting for age, the association was no longer significant （OR = 1.513,95%CI： 0.778-2.931,P = 0.221）. HUA was not an independent risk factor of CAD in both genders. （3） The distribution of diseased vessel numbers was significantly different in female patients with HUA and patients without HUA（Z = 2.51,P = 0.01）. The Gensini score was significantly higher in female patients with HUA than that of female patients without HUA（P 0.05）. The positive correlation was found between Gensini score and serum level of uric acid in the total woman group, HUA and non-HUA groups （rs =0.181,0.291,0.138,P 0.05 or P 0.01）. Conclusion： In women, HUA was associated with CAD, but it was not an independent risk factor for CAD. Particular attention should be paid in aged women patients with HUA in clinical CAD diagnosis.