世居高原人群血清尿酸以及同型半胱氨酸水平与冠状动脉慢血流现象的相关性研究

The Relationship Between the Levels of Serum Uric Acid,Homocysteine and Coronary Slow Flow Phenomenon in the Native People at High Altitude Area

目的：探讨世居高原人群血清尿酸（UA）以及血清同型半胱氨酸（Hcy）水平与冠状动脉慢血流现象（CSFP）的相关性。方法：入选2013年8月—2015年5月因胸痛并疑似冠心病于我科行冠状动脉造影检查,结果显示冠状动脉无明显狭窄且存在冠状动脉慢血流现象的患者30例为慢血流组,并随机选取同期行冠状动脉造影提示冠状动脉无明显狭窄且血流正常的患者30例为对照组。采用校正的TIMI血流计帧法（corrected TIMI frame count,CTFC）检测,其中CTFC值〉27诊断为冠状动脉慢血流。检测并记录相关临床资料进行统计分析,并对各个变量与冠状动脉慢血流的相关性进行多因素Logistic回归分析。结果：两组间年龄、性别、居住地海拔差异均无统计学意义（P〉0.05）;两组患者吸烟史、高血压病史、糖尿病史差异均有统计学意义（P〉0.05）;实验室检查资料血清C反应蛋白（CRP）、血浆纤维蛋白原（Fib）、红细胞计数（RBC）、血红蛋白测定（HGB）、红细胞比容（HCT）、血小板计数（PLT）与对照组差异均无统计学意义（P〉0.05）;血清尿酸（UA）、血清同型半胱氨酸（Hcy）、血清低密度脂蛋白（LDL-C）与对照组差异均有统计学意义（P=0.001;P=0.001;P=0.031）。多因素Logistic回归分析显示,在本研究进行统计的所有变量中,UA（OR=1.014,95%CI 1.001-1.027,P=0.036）;Hcy（OR=1.285,95%CI 1.076-1.535,P=0.006）是冠状动脉慢血流的危险因素。结论：血清UA与Hcy水平与高原地区冠状动脉慢血流现象的发生明确相关,可作为临床预测高原地区冠状动脉慢血流现象发生的危险因素。

Objective： To investigate the correlation between serum uric acid（ UA） and serum homocysteine（ Hcy） level and coronary slow flow phenomenon（ CSFP） in the native people at high altitude area. Methods： selected the inpatients because of chest pain and suspected coronary heart disease in our department for coronary angiography since August 2013 to May 2015. The results of coronary arteriongraphy（ CAG） showed that coronary artery without significant stenosis and coronary slow flow phenomenon in 30 cases were selected as trial group; and underwent coronary angiography suggest coronary artery stenosis and normal blood flow in 30 cases selected as the control group. Corrected TIMI frame count（ CTFC） was used to detect the coronary artery flow. The patients were diagnosed as coronary slow flow if CTFC value was large than 27. Detected and recorded the related clinical data for statistical analysis. group compared with independent sample t test; count data using chi square test. Logistic regression analysis,P〈0. 05 for differences have statistical significance. Results： The age,gender,place of residence and elevation differences in both groups had no statistical significance（ P〉0. 05）; the two groups of patients with a history of smoking,hypertension,diabetes,the differences were statistically significant（ P〉0. 05）; There were no significant differences（ P〉0. 05） in laboratory examination data concerned serum C- reactive protein（ CRP）,plasma fiber fibrinogen（ FIB）,red blood cell count（ RBC）,hemoglobin（ Hgb）,red blood cell hematocrit（ HCT） and platelet count（ PLT） in both groups; but the differences were statistically significant（ P = 0. 001,P =0. 001,P = 0. 031） in serum uric acid（ UA）,serum homocysteine（ Hcy） and serum low density lipoprotein（ LDL- C）. Multivariate logistic regression analysis showed that in the statistics of all the variables,both the UA（ OR= 1. 014,95% CI 1. 001 - 1. 027,P = 0. 036） and Hcy（ OR = 1. 285,95% CI 1. 076 - 1. 535,P = 0. 006） were the risk factors of coronary slow flow. Conclusion： Serum levels of UA and Hcy are related to the occurrence of coronary slow flow,which can be used as a risk factor for the occurrence of coronary slow flow at high altitude area.