高血压患者血尿酸水平与冠状动脉粥样硬化性心脏病的相关性研究

Correlation between serum uric acid level and coronary artery disease in patients with hypertension

目的 探讨高血压患者血尿酸水平与冠状动脉粥样硬化性心脏病（冠心病）的相关性.方法 选取2012年1月至2014年12月在北京市第六医院心内科住院的高血压患者320例,依据冠状动脉CT或冠状动脉造影结果分为冠心病组（130例）与非冠心病组（190例）,比较2组患者血尿酸及高敏C反应蛋白（hs-CRP）水平.依据冠状动脉造影结果将冠心病组患者分为单支病变、双支病变和三支病变,比较不同冠状动脉病变患者血尿酸及hs-CRP水平.参照美国心脏病协会修订冠状动脉分段方法进行分段,将冠状动脉病变累计冠状动脉段数与血尿酸及hs-CRP水平进行相关性分析.结果 冠心病组血尿酸及hs-CRP水平明显高于非冠心病组[（388±56）μmol/L比（350±54） μmol/L、（7.5±3.7） mg/L比（6.5±3.3） mg/L],差异均有统计学意义（均P＜0.05）.单支病变患者血尿酸和hs-CRP水平分别为（381±56）μmol/L和（6.2±2.7） mg/L,双支病变患者分别为（390±47） μmol/L和（6.5±3.3） mg/L,三支病变患者分别为（396±54） μmol/L和（6.9±3.3） mg/L,随着冠状动脉病变严重程度增加,血尿酸、hs-CRP水平逐渐升高,差异有统计学意义（P＜0.05）.经Spearman相关分析,冠状动脉病变累及冠状动脉段数与血尿酸和hs-CRP水平均呈正相关（r=0.59,P=0.02;r =0.49,P=0.03）.结论 高血压患者血尿酸水平与冠心病及其严重程度密切相关.

Objective To explore the correlation between serum uric acid level and coronary heart disease in patients with hypertension.Methods Three hundred and twenty patients with hypertension from January 2012 to December 2014 were selected and divided into CHD group （130 cases） and non-CHD group （190 cases） by coronary CT or coronary angiography findings.The patients in CHD group were divided into single-branch lesion,two-branch lesion and three-branch lesion subgroup,according to the coronary angiography.The serum uric acid and high sensitivity C reactive protein （hs-CRP） were measured and compared.The lesion segments were calculated based on revised Coronary Segmentation Method of American Heart Association;the correlation between accumulated number of lesion segments and uric acid or hs-CRP levels was analyzed.Results The serum uric acid was higher in CHD group than that in non-CHD group [（388 ±56）μmol/L vs （350 ±54）μmol/L],so was the hs-CRP [（7.5 ± 3.7） mg/L vs （6.5 ± 3.3） mg/L] （both P 〈 0.05）.Levels of the uric acid and hs-CRP significantly increased with the degree of coronary artery lesions [single-branch lesion：（381 ± 56） μmol/L and （6.2 ± 2.7） mg/L,two-branch lesion：（390 ± 47） μmol/L and （6.5 ± 3.3） mg/L,three-branch lesion：（396 ± 54） μmol/L and （6.9 ± 3.3） mg/L] （P 〈 0.05）.Spearman correlation analysis revealed that the number of lesion-segments was positively correlated with serum uric acid and hs-CRP （r =0.59,P =0.02;r =0.49,P =0.03）.Conclusion The serum uric acid level is correlated with the severity of coronary artery disease in patients with hypertension.