老年STEMI血尿酸对冠脉病变严重程度及预后分析

Analysis of Serum Uric Acid on Coronary Artery Leasion and Prognosis in the Elderly Patients With ST-segment Elevation Myocardial Infarction(STEMI)

目的探讨血尿酸与老年急性ST段抬高型心肌梗死(STEMI)患者的冠状动脉病变严重程度及预后的关系。方法回顾性分析2年内(2017年1月—2018年12月)于中国医科大学附属第四医院住院首次行冠状动脉造影的171例老年(年龄≥60岁)STEMI患者。根据血尿酸水平分为高尿酸血症组(25例)及正常组(146例),根据冠脉病变支数分为单支病变组(85例)、两支病变组(59例)及三支病变组(27例)。比较入院临床资料;分析两组中冠脉病变程度;分析两组心脏彩超检查。结果(1)高尿酸血症组SYNTAX评分[(19.98±2.01)分]显著高于正常组[(13.45±2.03)分],两组比较差异有统计学意义(P<0.05);在亚组冠脉病变支数两支及三支病变中,SYNTAX评分在高尿酸血症组均高于正常组,均有统计学意义(P<0.05);(2)两组比较,左室射血分数(LVEF)有明显差异(P<0.05)。结论在老年STEMI患者中,血尿酸水平与冠状动脉病变严重程度及其预后有重要意义。

Objective To investigate the relationship between serum uric acid and the severity and prognosis of coronary artery disease in elderly patients with acute ST-segment elevation myocardial infarction(STEMI).Methods 171 elderly patients with STEMI who underwent coronary angiography for the first time in the Fourth Hospital of China Medical University in two years(from January 2017 to December 2018)were retrospectively analyzed.The included patients were divided into hyperuricemia group(25)and normal group(146)according to the level of serum uric acid.According to the number of coronary artery lesions,they were divided into single-vessel lesion group(85),two-vessel lesion group(59)and threevessel lesion group(27).We compared the basic clinical data of the patients,and analyzed the degree of coronary artery lesions and the results of color Doppler echocardiography examination.Results(1)The SYNTAX score in hyperuricemia group[(19.98±2.01)scores]was significantly higher than that in normal group[(13.45±2.03)scores](P<0.05).In the subgroup with two or three coronary lesions,the SYNTAX score in hyperuricemia group was higher than that in normal group(P<0.05).(2)The left ventricular ejection fraction(LVEF)was significantly different between the two groups(P<0.05).Conclusion In elderly STEMI patients,serum uric acid is related to the severity of coronary artery disease and its prognosis.