摘要
目的研究血清尿酸对急性心肌梗死（AMI）患者院内死亡及心源性休克的预测价值。方法回顾性收集2010-09-2012-09在我院住院的181例AMI患者病历资料：男性154例（85．1％），女性27例（14．9％），年龄（66．2±13．4）岁，其中在住院期间发生院内死亡及心源性休克79例（43．6％）作为观察组，另外102例（56．4％）作为对照组。回顾住院资料，收集既往病史及相关实验室检查数据，其中血清尿酸、超敏C-反应蛋白、前白蛋白数值为入院次日早晨空腹静脉血样本测得。对相关临床数据统计描述及进行单变量、多变量Logistic回归分析。结果单变量Logistic回归提示，观察组合并糖尿病比例高（P＝0．025）、血清尿酸水平高（P＝0．031）。临床指标纳入Logistic回归模型，经变量剔除，血清尿酸（OR＝1．006，95％CI1．002-1．010，P＝0.002）和糖尿病（OR＝2．459，95％CI1．064-5．680，P＝0．035）进入回归模型。结论AMI患者入院初期的血清尿酸水平是院内死亡、心源性休克发生的独立预测因素，对合并高尿酸的AMI患者需高度重视，并及早采取措施防止不良事件的发生。
Objective To investigate the predictive value of serum uric acid for hospital mortality and cardiac shock in patients with acute myocardial infarction.Methods A total of 181 patients with myocardial infarction （ male：n=154, 85.1% vs.female： n=27, 14.9%） admitted to the First Affiliated Hospital of Soochow University from Sep.2010 to Sep.2012 were enrolled.They were divided into an observation group （n=79, 43.6%） of hospital mortality and cardiac shock and a control group （n=102, 56.4%）.The levels of serum uric acid were measured from the vein blood in the morning of the 2nd day after admission.Clinical data were analyzed by univariate and multivariate logistic regression model.Results The serum level of uric acid （μmol/L） of observation group was significantly higher than the control group [350.5 （300.0, 457.0） vs.326.5 （279.5, 390.0）, P=0.031].Serum uric acid （OR=1.006, 95%CI：1.002 to 1.010, P=0.002） and diabetes mellitus （OR=2.459, 95% CI：1.064 to 5.680,P=0.035） were both determined as the independent risk factors of hospital mortality and cardiac shock by multivariate logistic regression model.Conclusion Serum uric acid is an independent risk factor for hospital mortality and cardiac shock in patients with acute myocardial infarction.Patients with high level of serum uric acid at admission should be paid more attention, and effective measures should be taken for them.
出处
《中国急救医学》
CAS
CSCD
北大核心
2014年第11期1006-1008,共3页
Chinese Journal of Critical Care Medicine
