高尿酸血症与高甘油三酯血症对冠状动脉风险的联合评估价值

Hyperuricemia and hypertriglyceridemia in acute coronary event risk

目的探讨高尿酸血症和高甘油三酯血症对冠状动脉病变风险的联合评估价值。方法对195例冠心病患者和69例非冠心病患者进行对比研究,分析尿酸和甘油三酯(TG)水平的差异。结果冠心病患者的尿酸及TG水平高于对照组。经多元逐步回归分析显示年龄、糖尿病、纤维蛋白原和尿酸与冠状动脉病变程度存在有意义的回归关系。联合评估发现高尿酸水平(≥416μmol/L)及高TG水平(≥2.33mmol/L)的患者发生冠状动脉事件的风险较单一指标发生冠状动脉事件的风险明显增加,OR值为3.13。糖尿病患者在相应的尿酸和TG水平下,冠状动脉病变程度明显升高。结论联合应用尿酸和TG评估急性冠状动脉事件的发生可能有一定意义。综合考虑患者体内的嘌呤代谢和脂质代谢,尤其对于糖尿病患者更为重要,也更有利于临床医师合理评价冠状动脉风险。

Objective To evaluate the clinical sigifacance of hyperuricemia and hypertriglyceridemia in acute coronary event risk. Methods Uric acid（ UA ） and triglyeeride（ TG ） levels were compared in 195 cases of coronary heart disease and 69 cases of non-coronary heart disease. Results UA and TG levels of coronary heart disease patients were higher than those of control group. Multiple stepwise regression analysis revealed that the age,diabetes mellitus ,flbrinogen and UA were associated with coronary artery lesion degree. The patients with high levels of UA （ 〉416 umoL/L） and TG （〉2.33 mmoL/L} were more likely to experience coronary event risk than the patients with only high level of UA or TG （ OR = 3.13 ）. The diabetes patients with the same level of UA and TG suffered from increased degree of coronary artery lesion. Conclusion Combined UA and TG are of great significance in evaluating the incidence of acute coronary artery event. Purine and lipid metabolism are important in diabetes patients and are more helpful for physician to evaluate coronary artery risk.