老年STEMI伴高尿酸血症患者冠状动脉病变特点分析

Characteristic Analysis of Coronary Artery Lesion in Elderly Patients with ST-segment Elevation Myocardial Infarction and Hyperuricemia

目的探讨高尿酸血症与老年急性ST段抬高型心肌梗死(STEMI)患者的冠状动脉病变严重程度的关系。方法回顾性分析2年内连续住院首次行冠状动脉造影的STEMI患者451例。根据患者的年龄分为老年组及中青年组,再根据血尿酸水平分为高尿酸组及正常组。比较入院临床资料;分析高尿酸组及正常组中冠脉病变程度;对老年组冠状动脉病变程度进行多元线性回归,探讨血尿酸与冠状动脉病变程度的关系。结果老年组中,高尿酸组Gensini评分[(110.5±52.2)μmol/L]显著高于正常组[(88.3±43.3)μmol/L],差异有统计学意义(P<0.05);中青年组中,高尿酸组Gensini评分[(72.5±42.5)μmol/L]与正常组[(72.8±36.7)μmol/L]未见明显差异(P>0.05)。老年组中,高尿酸组病变冠状动脉支数(2.74±0.70)明显高于正常组(2.34±0.82),差异有统计学意义(P<0.05);中青年组中,正常组病变支数(1.93±0.69)大于高尿酸组(2.13±0.84),2组比较未见统计学差异(P>0.05)。在老年组中,年龄及血尿酸与Gensini评分呈线性相关(P<0.05)。结论在STEMI患者中,老年组冠状动脉病变程度较中青年组重;在老年STEMI患者中,血尿酸水平与冠状动脉病变严重程度存在线性相关,且为正相关。

Objective To discuss the relationship between hyperuricemia and the severity of coronary artery lesion in the elderly patients with acuteST-segment elevation myocardial infarction（STEMI）.MethodsThe retrospective study enrolled 451 consecutive patients diagnosed with STEMIand underwent coronary angiography for the first time in two years. According to age,they were divided into 2 groups：the elderly group and the youngmiddle-aged group and were subdivided into the hyperuricemic group and the normouricemic group according to the serum uric acid level. Their ba-sic information at admission was compared. The severity of coronary artery lesion was analyzed in the hyperuricemic group and the normouricemicgroup. Finally,the multiple linear regression of severity of coronary artery lesion was made in the elderly group in order to discuss the relationship be-tween serum uric acid and the severity of coronary artery lesion.ResultsIn the elderly group,Gensini score of the hyperuricemic group was signifi-cantly higher than that of the normouricemic group,and the difference between the two groups was statistically significant（110.5±52.2 μmol/L vs88.3±43.3 μmol/L,P〈0.05）. In the young and middle-aged group,Gensini score was not statistically different in the two subgroups（72.5±42.5μmol/L vs 72.8±36.7 μmol/L,P〈0.05）. In the elderly group,the number of stenosed coronary vessels of the hyperuricemic group was significantlyhigher than that of the normouricemic group（2.74±0.70 vs 2.34±0.82,P〈0.05）. In the young and middle-aged group,the number of stenosed coro-nary vessels was not statistically different in the two subgroups（1.93±0.69 vs 2.13±0.84,P〈0.05）. In the elderly group,the result showed that ageand serum uric acid were linear correlated to the Gensini score（P〈0.05）.ConclusionIn patients diagnosed with STEMI,the severity of coro-nary artery lesion in the elderly group is more severe than that in the young and middle-aged group. As to the elderly patients with STEMI,positivelinear correlation is found between serum uric acid level and severity of coronary artery lesion.