冠心病患者血尿酸水平与冠状动脉病变程度的相关性研究

Study on the Correlation between Serum Uric Acid and Severity of Coronary Artery Disease in Patients with Coronary Heart Disease

目的探讨冠心病患者血尿酸水平与冠状动脉病变程度之间的相关性。方法 202例冠心病患者及50例非冠心病患者(对照组)分别测定血尿酸水平,用Gensini评分评估冠脉病变严重程度。以血尿酸水平四分位数为切点将冠心病患者分为四组:第1四分位数组(n=50),第2四分位数组(n=51),第3四分位数组(n=49),第4四分位数组(n=52),比较五组间一般资料及组间冠脉造影结果。结果五组间组颈动脉斑块检出率、HDL-C、血尿酸(UA)水平及Gensini评分差异有统计学意义(P<0.05),第4分位数组多支病变检出率明显高于对照组及第1四分位数组(P<0.05)。相关分析发现,在控制了年龄、性别的影响后,血UA仍与Gensini评分正相关(r=0.148,P=0.023)。线性回归分析,冠心病患者UA与Gensini评分密切相关,多元逐步回归分析提示UA为Gensini评分独立危险因素(β=0.159,P=0.037)。结论冠心病患者中血尿酸与Gensini评分正相关。冠心病患者血尿酸水平是反映冠脉病变严重程度的重要独立指标。

Objective To investigate the correlation between serum uric acid level and severity of coronary artery disease in patients with coronary heart disease. Methods The serum uric acid level of 202 patients with coronary heart disease and 50 pa- tients with non-coronary heart disease （ control group） was measured, at same time the severity of coronary artery disease was as- sessed by Gensini score. The patients with coronary heart disease were divided into four groups according to the quartile of serum u- ric acid level ： the first quartile group （ n = 50 ） , the second quartile group （ n = 51 ） , the third quartile group （ n = 49 ） , the fourth quartile group （n = 52）. The general information and coronary angiography results were compared between 5 groups. Results The detection rate of carotid artery plaque, HDL-C, uric acid （UA） and Gensini score were statistically significant between 5 groups （ P 〈 0. 05 ）, and the detection rate of multi-vessel disease in the fourth quartile was significantly higher than that of control group and the first quartile group（ P 〈 0. 05 ）. Correlative analysis revealed that blood UA was still positively correlated with Gensini score （ r = 0. 148 ,P =0. 023 ）after the effects of the age and sex were controlled. Linear regression analysis revealed that UA was associated with Gensini scores in patients with coronary heart disease and multivariate stepwise regression analysis suggested that UA was an independent risk factor for Gensini score （ b = 0. 159,P = 0. 037 ）. Conclusion Serum uric acid is positively correlated with Gensi- ni score in patients with Coronary heart disease. The level of serum uric acid in patients with coronary heart disease is an important independent indicator of the severity of coronary artery disease.