入院时尿酸水平与急性心肌梗死患者预后的相关性分析

Relationship between gigher serum uric acid on admission and prognosis after acute myocardial infarction

目的评估急性心肌梗死(AMI)患者入院时的血清尿酸(SUA)水平与其短期死亡率及长期生存率之间的相关性。方法连续入选该院CCU收治的症状发作48h之内的AMI患者,记录入院时的SUA及其他实验室检查结果。主要终点为短期(住院期间或症状首次发作30d内)死亡率,次要终点为远期(出院后或症状首次发作30d后)全因死亡率。结果共入选523名患者,男性312例,女性211例,平均(67.3±15.6)岁。校正其他危险因素后,入院时高的SUA水平与AMI后高的住院死亡率(RR,1.016;95%CI,1.001-1.031,P=0.043)、高的30 d死亡率(RR,1.016;95%CI,1.003-1.029,P=0.018)、以及远期生存率的下降(HR,1.105;95%CI,1.020-1.195,P=0.010)独立相关。结论入院时(症状发作48h内)高的SUA与AMI后高的短期死亡率和低的远期生存率相关。

【Objective】 To assess serum uric acid（SUA） levels determined on admission as a potential predictor of short-term mortality and long-term survival in acute myocardial infarction（AMI） patients.【Method】 We included consecutive patients with verified AMI admitted within 48 hours since the symptom onset.The primary end point was short-term mortality（in-hospital and thirty-day）,secondary end points were long-term survival（long-term all-cause mortality）.【Result】 A total of 523 patients（312 men,age 67.3±15.6 years） were included.Higher SUA on admission was independently associated with higher in-hospital mortality（RR,1.016;95%CI,1.001-1.031,P =0.043） and higher thirty-day mortality（RR,1.016;95%CI,1.003-1.029,P =0.018）.Higher SUA on admission was also independently associated with poorer long-term survival（higher all-cause mortality）（HR,1.105;95% CI,1.020-1.195,P =0.010）.【Conclusion】 Higher serum uric acid on admission is associated with higher short-term mortality and poorer long-term survival after AMI.