血尿酸与冠状动脉粥样硬化程度的关系

A study on relationship between severity of coronary atherosclerosis and serum uric acid level

目的明确血尿酸与冠状动脉粥样硬化程度之间的关系。方法回顾性分析复旦大学附属中山医院心导管室的冠状动脉造影病例205例,将其冠状动脉病变按Gensini积分系统进行评定,将血尿酸及其他28项生理、生化指标包括总胆固醇/高密度脂蛋白胆固醇(TC/HDL-C)、低密度脂蛋白胆固醇/高密度脂蛋白胆固醇(LDL-C/HDL-C),载脂蛋白A/载脂蛋白B(apoA/apoB)与Gensini积分之间行二变量的Spearman相关性分析,并将血尿酸与Gensini积分之间作控制年龄、性别变量后的偏相关分析,再将Gensini积分与各危险因素作多元逐步回归分析。结果血尿酸、白细胞计数、单核细胞计数、餐后两小时血糖、LDL-C、非高密度脂蛋白胆固醇(non-HDL-C)、apo-B、糖基化血红蛋白(HbA1c)、高敏C反应蛋白(hs-CRP)、TC/HDL-C、LDL-C/HDL-C与Gensini积分存在正相关关系,HDL-C、apoA/apoB与Gensini积分存在负相关关系。在控制年龄、性别变量后血尿酸仍与Gensini积分存在线性剂量反应关系。多元逐步回归分析显示血尿酸、吸烟指数为冠状动脉粥样硬化的独立危险因素。结论血尿酸与冠状动脉粥样硬化程度之间存在线性剂量反应关系,血尿酸为冠状动脉粥样硬化程度的独立危险因素。

Objective To investigate the relationship between severity of coronary atherosclerosis and serum uric acid level.Methods The study population consisted of 205 consecutive patients who underwent coronary angiography for suspected or known coronary atherosclerosis.The severity of coronary atherosclerosis was defined by Gensini＇s score.The Spearman two-way test and partial correlation analysis was used to assess the relationship between two quantitative variables.Multivariate stepwise linear regression analysis was employed to explore the relationship between twenty-nine factors including the Gensini＇s score and serum uric acid level.Results Spearman＇s correlation analysis indicated that serum uric acid level was positive correlated with Gensini＇s score（r =0.144,P =0.044）,and partial correlation analysis showed that serum uric acid level was still positive correlated with Gensini＇s score （r =0.1419,P =0.048）while the disturbant variables were under control.Multiple stepwise linear regression analysis demonstrated that serum uric acid level was significantly independently associated with the severity of coronary atherosclerosis（β =0.891,P =0.002）.Conclusions There is a linear dose-response relationship between serum uric acid level and the severity of coronary atherosclerosis as measured by Gensini＇s score.Serum uric acid level is independently associated with the severity of coronary atherosclerosis.