血尿酸水平与急性ST段抬高型心肌梗死的相关性研究

Correlation between serum uric acid levels and acute ST-elevation myocardial infarction

目的探讨急性ST段抬高型心肌梗死(STEMI)与血尿酸水平的相关性。方法收集中国人民解放军总医院2012年1月至2014年10月因STEMI行急诊冠状动脉介入(PCI)的357例患者的临床资料,其中血尿酸正常组患者261例,高尿酸血症组患者96例,比较所有患者血尿酸水平与冠脉病变支数的关系以及两组患者的基线资料、心脏功能和院内死亡率等。结果高尿酸血症组患者的体重、体质指数、心率、高血压病患病率、血脂异常患病率、胆固醇、甘油三酯、低密度脂蛋白胆固醇水平以及左室舒张末内径(LVEDD)均较血尿酸正常组高,差异均有统计学意义(P<0.05),其高密度脂蛋白胆固醇水平及左室射血分数(LVEF)均较血尿酸正常组低,差异均有统计学意义(P<0.05),两组患者的住院时间及院内死亡率差异均无统计学意义(P>0.05);血尿酸水平与胆固醇、甘油三酯及低密度脂蛋白胆固醇水平均呈正相关(P<0.05),与高密度脂蛋白胆固醇水平呈负相关(P<0.05);冠状动脉单、双支及三支病变患者的血尿酸水平分别为(320.23±105.79)μmol/L、(345.14±88.97)μmol/L、(375.32±113.38)μmol/L,呈递增关系,且各组血尿酸水平的差异有统计学意义(F=8.259,P=0.000)。结论在急性STEMI患者中,高尿酸血症患者冠脉病变程度更严重,且心功能差,血脂、血糖代谢紊乱水平高。

Objective To study the correlation between acute ST-elevation myocardial infarction （STEMI） and the levels of serum uric acid. Methods The clinical data of 357 patients with acute STEMI admitted in Chinese PLA General Hospital from January 2012 to October 2014 were collected, including 261 patients with normal serum uric acid （normal serum uric acid group） and 96 patients with hyperuricemia （hyperuricemia group）. The correlation between serum uric acid levels and count of diseased coronary arteries was analyzed, and the baseline demographics, left heart function, in-hospital mortality were compared between the two groups. Results Patients in hyperuricemia group had a larger weight, body mass index, heart rate, incidence of hypertension, incidence of dyslipidemia, cholester-ol level, triglyceride level, low density lipoprotein cholesterol level, left ventricle end diastolic diameter （LVEDD） and a smaller left ventricle ejection fraction （LVEF）, high density lipoprotein cholesterol level than the patients in normal serum uric acid group （P〈0.05）. The length of hospital stay and incidence of in-hospital mortality between the two groups showed no statistically significant difference （P〉0.05）. Serum uric acid level was positively correlated with cholesterol, tri-glyceride, low density lipoprotein cholesterol, and negatively correlated with high density lipoprotein cholesterol level （P〈0.05）. The serum uric acid level in patients of one diseased coronary artery, two diseased coronary arteries and three dis-eased coronary arteries was （320.23±105.79） μmol/L, （345.14±88.97） μmol/L and （375.32±113.38） μmol/L, respectively, and the differences were statistically significant （F=8.259, P=0.000）. Conclusion In patients with STEMI, those with hyperuricemia suffer from severer coronary arteries lesion, metabolic disorders and worse left heart function.