不同尿酸水平老年冠心病患者血管内超声检查结果比较研究

A comparative study of intravascular ultrasound findings in elderly coronary heart disease patients with different uric acid levels

目的探讨不同尿酸水平的老年冠心病患者血管内超声检查结果的差异.方法选取本院2017年12月至2020年5月收治的老年冠心病确诊患者145例为观察对象,所有患者均接受尿酸和血管内超声检查,根据患者的尿酸水平将其分为A组(尿酸≤199μmol/L)、B组(尿酸200~399μmol/L)和C组(尿酸≥400μmol/L),对三组患者的血管内超声检查指标进行对比分析.结果A组与B组患者左主干狭窄程度均低于C组(F=5.625,P=0.039);B组与C组患者斑块纤维帽厚度并无明显差异,均小于观察A组(F=7.825,P=0.020);A、B和C三组患者的斑块面积分别是[(8.29±3.14)mm^(2),(11.12±1.73)mm^(2)和(14.67±0.91)mm^(2),F=6.384,P=0.028]、斑块最大厚度分别是[(1.38±0.09)mm,(1.76±0.24)mm和(2.19±0.18)mm,F=6.827,P=0.015]均存在明显差异,由低到高依次为A组、B组、C组.结论老年冠心病患者机体尿酸水平升高可导致斑块面积、斑块厚度增加,并引起斑块纤维帽厚度减小,导致不稳定斑块形成风险增加,严重威胁患者的生命安全,应加强此类患者机体尿酸的监控与调节.

Objective To explore the differences in intravascular ultrasound results in elderly coronary heart disease(CHD)patients with different uric acid levels.Methods A total of 145 elderly patients diagnosed with CHD in our hospital from December 2017 to May 2020 were included as study subjects.Uric acid levels were measured and intravascular ultrasound examination was conducted in all patients.They were divided into different groups based on uric acid levels:Group A(uric acid≤199μmol/L),Group B(uric acid 200~399μmol/L)and Group C(uric acid≥400μmol/L).Data from intravascular ultrasound-derived indexes were analyzed and compared between the three groups.Results There was no significant difference in the degree of left main stenosis between Group A and Group B,but it was less severe in both groups than in Group C(F=5.625,P=0.039).Plaque fibrous cap thickness showed no significant difference between Group B and Group C,but it was smaller than in Group A(F=7.825,P=0.020).Group C had the largest plaque area and maximum thickness among the three groups,followed by Group B[(11.12±1.73)mm^(2)and(1.76±0.24)mm]and Group A[(8.29±3.14)mm^(2)and(1.38±0.09)mm](F=6.384 and 6.827,P=0.028 and 0.015).Conclusions Elevated uric acid levels in elderly CHD patients can increase the area and thickness of plaques,and reduce plaque fibrous cap thickness,leading to an increased risk of formation of unstable plaques,which can be life-threatening for these patients.Thus,monitoring and managing uric acid levels should be stressed in elderly CHD patients.