血尿酸与冠状动脉粥样硬化性心脏病的相关性研究

Study on relationship between the level of serum uric acid and coronary heart disease

目的 探讨血尿酸水平与冠状动脉粥样硬化性心脏病（冠心病）的相关性.方法 选择104例冠心病患者分为稳定型心绞痛组30例、不稳定型心绞痛组43例、急性心肌梗死组31例,选择冠脉造影检查正常者21例为对照组,测定并比较各组血尿酸、肌酐、尿素氮及血脂水平,分析血尿酸水平与冠心病之间的关系.结果 冠心病组血尿酸、肌酐、尿素氮水平均高于正常对照组[（410.59±81.83）μmol/L比（289.95±42.30）μmol/L,（94.62±32.91）mmol/L比（74.76±6.32）mmol/L,（5.75±1.57）μmol/L比（4.82±0.91）μmol/L],差异有统计学意义（P＜0.05）;冠心病亚组间,稳定型心绞痛组、不稳定型心绞痛组、急性心肌梗死组血尿酸、肌酐、尿素氮水平依次升高[（311.68±78.85）μmol/L、（420.09±85.70）μmol/L和（476.65±68.65）μmol/L,（80.66±13.67）mmol/L、（92.35±16.90）mmol/L和（109.71±45.32）mmol/L,（4.95±1.35）μmol/L、（5.89±1.26）μmol/L和（7.27±1.80）μmol/L],两两比较,差异均有统计学意义（P＜0.05）.经Spearman秩相关分析显示,血尿酸水平与尿素氮、肌酐、甘油三酯呈正相关（rs=0.239、0.367、0.213,P＜0.05）,与高密度脂蛋白呈负相关（rs=-0.347,P＜0.05）,而与总胆固醇、低密度脂蛋白无明显相关性（rs=-0.33,0.139,P＞0.05）.结论 血尿酸水平与冠心病及其危险因素密切相关,且与冠心病严重程度呈正相关,其水平升高是冠心病发生的重要危险因素之一,可对冠心病患者病情及预后起警示作用.

Objective To study the relationship between the level of serum uric acid （UA） and coronary heart disease （CHD） defined by selective coronary anglography （SCAG）. Methods 104 inpatients with coronary heart disease were divided into three groups, the stable angina peetoris group （SAP） including 30 cases,the unstable angina pectoris group（UAP） including 43 cases and the acute myocardial infarction group（AMI） including 31 cases. 21 patients who had normal coronary artery were chosen as the control group. The level of serum uric acid（UA）,creatinine（Cr）, blood urea nitrogen（BUN） and lipids were determined. The results of each group were compared and the relationship between UA and CHD was analyzed. Results Compared with the control group, the level of UA,Cr,BUN in the CHD group was higher [（410.59±81.83）μmul/L vs （289.95±42.30）μmol/L, （94.62±32.91）mmol/L vs （74.76±6.32）μmol/L, （5.75±1.57）μmol/L vs （4.82±0.91）μmol/L]. The differences were significant （P〈0.05）. Within the subgroup of CHD, the level of UA, Cr, BUN in the SAP group, the UAP group and the AMI group increased successively E （ 311.68±78.85 ）μmol/L vs （420.09 ±85.70 ） μmol/L vs （476.65 ±68.65 ） μmol/L, （80.66±13.67）mmol/L vs （92.35±16.90）mmol/L vs （109.71±45.32）mmol/L, （4.95±1.35）μmol/L vs （5.89±1.26）μmol/L vs （7.27±l.80）μmol/L]. Compared with each other, the differences were all significant （P〈 0.05）. Spearman rank correlation analysis revealed that the level of serum uric acid was positively related to BUN, Cr and TG （rs=0.239,0.367,0.213,P〈0.05）, negatively related to HDL （rs=-0.347,P〈0.05）, and irrelevant to TC, LDL（rs=-0.33,0.139,P〉0.05）. Conclusion The level of serum uric acid is closely related to coronary heart disease and its risk factors. And it is positively correlated to the severity of coronary heart disease. High level of these indicators may be one of important risk factors for the presence of coronary heart disease. It can serve as a warning of CHD patients＇ condition and prognosis to doctors.