血尿酸与冠心病患者左室功能的相关性研究

Correlation between Left Ventricular Function in Patients with Coronary Heart Disease Hyperurieimia

目的研究表明血尿酸是心血管疾病的危险因素,心血管疾病的心脑血管事件病死率及全因病死率在血尿酸升高患者中明显升高。本研究采用超声心动相关技术评价冠心病患者收缩及舒张功能,探讨尿酸对冠心病患者左室收缩、舒张功能的影响。方法入选住院冠心病患者138例,根据血尿酸水平(男性≥420μmol/L,女性≥357μmol/L)将其分为两组:高尿酸组(n=30)与正常组(n=108),两组间年龄、性别、高血压、糖尿病、吸烟、饮酒等一般情况相匹配。为评价冠心病患者收缩与舒张功能,采用了传统的心脏超声学方法及组织多普勒方法,指标包括:跨二尖瓣的早期血流流速(E)和晚期血流流速(A),左室射血分数(EF),短轴缩短率(FS),二尖瓣环室间隔侧及侧壁侧心肌早期舒张峰值速度(E1'、E2')和晚期舒张峰值速度(A1'、A2'),左室等容收缩时间(IVCT)、等容舒张时间(IVRT)、射血时间(ET)和Tei指数[Tei=(IVCT+IVRT)/ET]。比较两组间收缩及舒张功能指标是否有差异。结果高尿酸组与正常尿酸组相比E1'、A1'、E/E1'、E/E2'、Tei指数、EF、FS的差异有统计学意义。尿酸与超声学指标间相关性分析显示尿酸与E/E1'、Tei指数、EF、FS相关。结论血尿酸升高影响冠心病患者心脏收缩与舒张功能。

Objective Hyperuricemia （HU） is a well - recognized risk factor for cardiovascular diseases. The possible contributory effect of HU on myocardial impairment produced by Coronary heart disease（CHD） , however, has not been clarified yet. This study was designed to investigate the relationship between HU and left ventrieular （LV） function in Coronary heart disease（ CHD）. Methods Total- ly 138 CHD patients were enrolled and they were divided into two groups by the level of serum uric acid （SUA） （male≥420μmol/L, fe- male ≥ 357μmol/L） ： age, sex and body mass index were matched in HU group and normal group. To estimated the LV diastolic function, the following parameters were measured by tissue Doppler imaging （TDI） and traditional Doppler Echocardiogrophy：the early transmitral inflow （E） and late transmittal flow （A）, the early lateral mitral annulus velocity （E′） and late lateral mitral annulus velocity （A′）, the ratio of early transmittal inflow to mitral annular velocity （E/E′） , the isovolumic relaxation time （IVRT）, isovolumic contraction time （ IVCT）, and ejection fraction time （ ET）, the Tei index [ Tei = （ IVRT ＋ IVCT）/ET ]. And ejection fraction （ EF）, FS for the LV systolic function. The parameters between the two groups were compared. Results In the HU group the E/E′（P = 0. 000） was significantly high- er. The serum uric acid had a positive correlation with the E/E′（P = 0. 000）. Conclusion Our data suggest that HU is associated with LV systolic and diastolic dysfunction in CHD.