冠心病患者血尿酸及糖化血红蛋白水平与冠脉病变的关系

Correlation between the level of serum uric acid,glycosylated hemoglobin A1c and the coronary lesions in patients with coronary heart disease

目的:探讨冠心病患者血清尿酸(SUA)及糖化血红蛋白(HbA1c)水平与冠状动脉病变程度的关系及其临床意义。方法:270例接受冠脉造影的患者分为冠心病组(198例)和非冠心病组(72例),比较两组SUA及HbA1c水平。对冠心病组冠脉病变程度进行Gensini评分,分析SUA、HbA1c水平与Gensini积分的相关性。冠心病组以HbA1c水平分为A组(HbA1c≤6.5%,94例)和B组(HbA1c>6.5%,104例),分析两亚组SUA水平与Gensini积分的关系。结果:(1)冠心病组SUA、HbA1c水平高于非冠心病组[(341±100)μmol/L vs(289±75)μmol/L;(6.7±1.4)%vs(5.7±1.0)%;均P<0.01]。(2)相关性分析显示,冠心病组SUA及HbA1c水平与Gensini积分呈正相关(r=0.555,0.689,P<0.01),多元线性回归分析示仅HbA1c与Gensini积分存在回归关系(β=0.689,t=11.809,P<0.01),SUA未进入回归方程。(3)A组SUA水平与Gensini积分无相关性(r=0.194,P=0.110),B组SUA水平与Gensini积分正相关(r=0.380,P<0.01)。结论:HbA1c水平是冠脉病变程度的独立预测因子,SUA水平不能独立预测冠脉病变程度,高SUA并高HbA1c联合对冠脉病变程度有较高的预测价值。

Objective To study the correlation between the level of serum uric acid（SUA）,glycosylated hemoglobin A1c（HbA1c）and the coronary lesions in patients with coronary heart disease.Methods 270 patients were divided into the coronary heart disease（CHD） group（n = 198）and the control group（n = 72）to compared the level of SUA and HbA1c according coronary angiography.The severity of coronary stenosis was evaluated using the Gensini score,the correlations between the level of SUA,HbA1c and Gensini score were analyzed in CHD group.CHD group were divided into group A（HbA1c ≤ 6.5%,n = 94） and group B（HbA1c 6.5%,n = 104）.The correlation between the level of SUA and the Gensini score was analyzed in the two subgroups.Results（1）The levels of SUA and HbA1c of CHD group were higher than control group [（341 ± 100）μmol/L vs（289 ± 75）μmol/L,（6.7 ± 1.4）% vs（5.7±1.0）%,P 0.01].（2）The levels of SUA and HbA1c were positively correlated with Gensini score（r = 0.555,0.689,P 0.01）.Multivariate analysis showed HbA1c was significantly associated with Gensini score（β = 0.689,t = 11.809,P 0.01）,but SUA was not included in the regression equation.（3）There was no significant correlation between the level of SUA and Gensini score in subgroup A（r = 0.194,P = 0.110）,and the level of SUA was positively correlated with Gensini score in subgroup B（r = 0.380,P 0.01）.Conclusions The level of HbA1c is independently associated with the severity of the coronary stenosis,while the level of SUA is not a independent predictor of coronary stenosis.High level of SUA with high level of HbA1c is a more significant predictor for the severity of coronary stenosis.