冠心病患者血尿酸水平、凝血纤溶功能及其相关性研究

Correlation study of level of serum uric acid and change of blood coagulation and flbrinolysis in coronary heart disease patients

目的通过了解冠心病(CHD)患者血清尿酸(UA)水平和凝血纤溶功能变化及其相互联系,探讨血UA升高及凝血纤溶功能改变在CHD发生中的作用。方法选择急性冠脉综合征(ACS)、稳定型心绞痛(SAP)和对照组(CO)患者各30例,测定外周血UA、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FG)、D-二聚体(DD)水平,然后进行相关的统计学分析。结果ACS与CO组患者相比,血UA、FG、DD水平明显增高,而PT和APTT则明显缩短(均P<0.05);SAP与CO组患者相比,血UA水平明显增高,而PT、APTT、FG、DD则差异无统计学意义;ACS组和SAP组相比,血清UA水平差异无统计学意义(P>0.05),而血FG、DD水平明显增高,PT和APTT则明显缩短(均P<0.05)。SAP患者血UA与FG、DD成正相关(r分别为0.412、0.358,均P<0.05);ACS患者血UA与FG、DD成正相关(r分别为0.471、0.397,均P<0.05),与PT成负相关(r=-0.364,P<0.05)。不论是SAP组还是ACS组,其高尿酸血症(HUA)者与正常血UA者相比,血FG水平均明显增高(均P<0.05)。结论血清UA水平升高可能是CHD的一个危险因素,其可能通过影响凝血纤溶功能,促进血栓形成,导致了CHD的发生发展。

Objective： To elucidate the effect of elevated serum uric acid（UA） level as well as the change of blood coagulation and flbrinolysis in the pathogenesis of coronary heart disease（CHD） by exploring the level of serum UA,the change of blood coagulation and flbrinolysis and their correlation in CHD.Methods： The patients were selected with 30 cases of acute coronary syndrome（ACS）,30 of stable angina pectoris（SAP） and 30 as the controlled group（CO）, and the levels of serum UA and plasma prothrombin（PT）,activated partial thromboplastin（APTT）,fibrinogen（FG） and D-dimer（DD） were measured.Then all the data were evaluated with related statistical methods.Results： The levels of serum UA,plasma FG and DD were higher in the ACS group compared with those in the CO group（P〈0.05）,while the PT and APTT were shorter;and the serum UA level was higher in SAP group compared with those in the CO group（P〈0.05）,while there was no statistic difference in the plasma PT,APTT,FG,DD between the two groups（P〉0.05）;there was no statistic difference in the serum UA level in the ACS group compared with that in the SAP group,while the level of FG and DD were higher,the PT and APTT were shorter（P〈0.05）.The serum UA level was positively correlated with both the plasma FG and DD in SAP patients（r=0.412,0.358,P〈0.05）;and the UA level were positively correlated with both the plasma FG and DD in ACS patients（r=0.471,0.397,P〈0.05）,but negatively correlated with the PT（r=-0.364,P〈0.05）.Moreover,the levels of plasma FG were all higher in the higher serum UA patients in the SAP and the ACS groups,compared with those in the normal serum UA patients（P〈0.05）.Conclusion： The elevated serum UA is probably a risk factor of CHD and induces the pathogenesis and development of CHD by influencing the function of blood coagulation and flbrinolysis and promoting the thrombogenesis.