急性冠脉综合征患者血尿酸水平与冠脉病变程度的相关性及其对经皮冠状动脉介入术预后的影响

The correlation between serum uric acid level and the severity of coronary arterial lesions in acute coronary syndrome patients and the influence of serum uric acid on the post-operation of percutaneous coronary intervention

目的探讨血清尿酸（SUA）水平与急性冠脉综合征（ACS）患者冠脉病变程度的相关性及其对经皮冠状动脉介入术（PCI）预后的影响。方法对253例诊断为 ACS 且接受冠状动脉造影和 PCI 术的患者，测定血清尿酸水平。根据尿酸是否正常分成高尿酸组和正常尿酸组，比较两组间冠状动脉狭窄程度以及 PCI术中的冠脉血流情况，并随访 PCI 术后心功能变化以及一个月和半年的主要心血管不良事件（MACE）的发生率。结果高尿酸组 Gensini 积分明显高于正常尿酸组（P ＜0．01）。血清尿酸水平与 Gensini 积分呈正相关（r ＝0．301，P ＜0．05）。高尿酸组 PCI 术中慢血流的发生率为28．3％，明显高于正常尿酸组（10．5％），差异有统计学意义（P ＜0．01）。且血尿酸是 PCI 术中出现慢血流的独立预测因素（OR ＝5．579，95％CI 2．163～14．389，P ＜0．01）。术后心功能及随访期间 MACE 事件的发生率高尿酸和正常尿酸组之间并无明显差异（P ＞0．05）。结论ACS 患者血尿酸水平越高，冠脉狭窄程度越重；合并高尿酸血症的 ACS 患者接受 PCI 治疗时，发生冠脉慢血流的风险增加。

Objective To discuss the correlation between serum uric acid（SUA）level and the severity of coronary arterial lesions in acute coronary syndrome（ACS）patients and the influence of SUA on the post-operation of percutaneous coronary intervention（PCI）.Methods The SUA level of 253 patients who were diagnosed with ACS and underdone coronary angiography was measured.All patients were divided into hyperuricemia group and normal group accoding to the SUA level,the severity of coronary arterial lesions and the coronary artery flow in PCI was com-pared,.The cardiac function changes and the incidence of major adverse cardiovascular events （MACE）after PCI at one-month and half a year follow-up were record.Results The Gensini score of hyperuricemia group was significantly higher than that of normal uric group（P 〈0.01）.And the results of correlation analysis showed the correlation of ser-um uric acid level and Gensini score was positive（r =0.301,P 〈0.05）.The incidence of coronary slow flow in high uric acid group during PCI was 28.3%,which was higher than that in the normal group significantly.And SUA was an independent predictor of coronary slow flow during PCI（OR 5.579,95%CI 2.163-14.389,P 〈0.001 ）.However, there was no significant difference in the cardiac function and MACE between the two groups after PCI（P 〉0.05）. Conclusions The higher the level of SUA of ACS patients,the more serious the coronary arterial lesions.The risk of coronary slow flow increased in the patients complicated with hyperuricemia who undervent PCI.