颈动脉内膜中层厚度及尿酸水平与冠心病患者预后的相关性研究

Carotid intima-media thickness and uric acid level and the research of the prognosis of patients with coronary heart disease

目的 探讨颈动脉内膜中层厚度及尿酸水平对冠心病患者预后的预测价值.方法 采用随机数字表法将182例确诊为冠心病患者分为两组：A组：急性冠脉综合征（ACS组）92例,B组：稳定型心绞痛（SAP）90例,健康体检者90例为对照组（C组）,空腹抽血检测血尿酸,应用彩色超声多普勒测定颈动脉内膜中层（IMT）厚度.结果 A组尿酸、IMT、斑块指数[（428.5±70.3） mmol/L、（1.58 ±0.92） mm、（3.24±1.81）]与B组[（356.4±68.2） mmol/L、（1.32±0.86）mm、（3.08±1.62）]、C组[（251.2±65.4） mmol/L、（0.92±0.41）mm、（2.80±1.18）]差异均有统计学意义（A组与B组比较,t=4.47、3.26、5.21,P＜0.05,A组与C组比较,t=8.23、9.36、7.48,P＜0.01）;B组与C组差异有统计学意义（t=6.34、5.26、7.12,P＜0.05）;直线相关分析显示,尿酸与IMT厚度呈正相关,r值为0.67.A组颈动脉粥样硬化软斑块检出率60.9％与B组26.7％和C组8.9％差异有统计学意义（χ2=21.60,P＜0.05;χ2=69.11,P＜0.01）,B组相比C组差异有统计学意义（χ2=39.84,P＜0.01）.结论 尿酸水平和颈动脉粥样硬化与冠脉病变密切相关,为冠心病的危险评估及预后提供理论依据.

Objective To explore the carotid intima-media thickness and the value of uric acid in predicting the prognosis of coronary heart disease patients.Methods Using the random number table method,182 patients diagnosed with coronary heart disease were divided into two groups：group A was 92 cases of acute coronary syndrome （ACS）,groups B was 90 cases of chronic stable angina,healthy check-up 90 cases as control group （group C）,fasting blood test blood uric acid （UA）,application of color Doppler ultrasound measurement carotid intima-media thick ness （IMT）.Results Acute coronary syndrome （ACS） set of uric acid,IMT,plaque index were （428.5 ± 70.3） mmol/L,（1.58 ± 0.92） mm,（3.24 ± 1.81） and those in stable angina group were （356.4 ± 68.2） mmol/L,（1.32 ± 0.86） mm,（3.08 ± 1.62） and those of the control group were （251.2 ± 65.4） mmol/L,（0.92 ± 0.41） ram,（2.80 ± 1.18） to compare the difference was statistically significant（group A compared with group B（t =4.47,3.26,5.21,all P 〈 0.05）,group A compared with group C （t =8.23,9.36,7.48,all P 〈 0.01）;group SAP compared with control group the difference was statistically significant （t =6.34,5.26,7.12,all P 〈 0.05）;Linear correlation analysis showed that uric acid and carotid intima-media thickness were positively correlated,r value was 0.67.The ACS group soft carotid atherosclerosis plaque detection rate was 60.9%,SAP group was 26.7% and the control group was 8.9%,the difference was statistically significant （χ2 =21.60,P 〈 0.05;χ2 =69.11,P 〈 0.01）,group SAP compared with the control group,the difference was statistically significant （χ2 =39.84,P 〈 0.01）.Conclusion Uric acid levels and carotid artery atherosclerosis and coronary artery disease are closely related,which can provide theoretical basis for the risk assessment and prognosis of coronary heart disease.Early intervention can prevent the occurrence of serious cardiovascular events.