老年冠心病患者血尿酸水平与冠状动脉病变程度的相关性

Correlation of serum uric acid level with severity of coronary stenosis in elderly patients with coronary heart disease

目的探讨老年冠心病患者血尿酸水平与冠状动脉病变范围及狭窄程度的关系。方法选取289例经冠状动脉造影确诊冠心病（管腔狭窄≥50％）的70岁以上老年冠心病患者。采用Gensini积分评价冠状动脉病变严重程度。术前检查血尿酸水平。对比分析患者血尿酸水平与冠状动脉狭窄程度及范围的关系。结果289例患者中单支病变组、双支病变组和多支病变组患者的血尿酸水平差异无统计学意义[（0．358±0．102）w（0．379±0．112）VS（0．366±0．112），P〉O．05]，不同Gensini积分组患者的血尿酸水平差异无统计学意义[（0．360±0．100）坩（0．375±0．119）w（0．369±0．100）w（0．370±0．123），P〉0．05]，尿酸正常组与高尿酸血症组患者的Gensini积分差异无统计学意义[（37．138±24．934）w（41．887±35．294），P〉0．05]。单独分析男性患者和女性患者，单支病变组、双支病变组和多支病变组的血尿酸水平差异均无统计学意义，不同Gensini积分组患者的血尿酸水平差异无统计学意义。结论目前尚缺乏证据证明血尿酸水平可以作为老年冠心病患者冠状动脉病变严重程度的危险因素或预测因子。

Objective To evaluate the correlation between serum level of uric acid and severity of coronary lesions in elderly patients with coronary heart disease. Methods A cohort of 289 elderly patients with age over 70 years suffering from angiographically identified coronary artery disease （diameter stenosis ≥ 50% of lumen narrowing） admitted to our department from January 2011 to August 2012 were enrolled in this study. The severity of coronary artery disease was assessed by Gensini score. Preoperative serum uric acid level was measured with an automatic biochemical analyzer. The correlation of serum uric acid level with the extent and severity of coronary stenosis was analyzed. Results There was no significant difference in serum level of uric acid among the single-, double- and multiple-vessel lesion groups （0.358 ± 0.102） vs （0.379 ± 0.112） vs （0.366 ± 0.112）, P 〉 0.05. No significant difference was seen in serum level of uric acid among the senile with different severity of coronary artery stenosis （0.360 ± 0.100） vs （0.375 ± 0.119） vs （0.369 ± 0.100） vs （0.370 ± 0.123）, P〉 0.05. There was no significant difference in the severity of coronary artery stenosis （Gensini score） between normal uric acid group and hyperuricemia group （37.138 ± 24.934） vs （41.887 ± 35.294）, P 〉 0.05. For male and female patients, there was still no significant difference in serum uric acid levels among the single-, double- and multiple-vessel lesion groups. The patients with different Gensini scores had no significant difference in serum uric acid level. Conclusion No adequate evidence shows that serum uric acid level can be used as a risk factor or predictor for the severity of coronary lesions among elderly patients with coronary heart disease.