血尿酸对急性ST段抬高型心肌梗死患者长期预后的影响

Effect of serum uric acid level on long-term outcome in patients with acute ST-segment elevation myocardial infarction

目的探讨血尿酸对于急性ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)长期预后的影响。方法选择STEMI患者328例,按照血尿酸水平三分位法将患者分为A组111例(血尿酸≤290μmol/L)、B组109例(290μmol/L<血尿酸≤361μmol/L)和C组108例(血尿酸>361μmol/L)。比较3组住院期间主要不良心脑血管事件(MACCE),并长期随访。结果A、B、C组住院期间病死率分别为2.7%、4.6%、15.7%(P=0.000),住院MACCE发生率分别为9.9%、11.9%、27.8%(P=0.001);随访42.3个月显示,A、B、C组MACCE发生率分别为4.3%、11.1%、20.9%(P=0.003)。Cox回归分析显示,血尿酸是STEMI患者远期MACCE的独立预测因素。结论血尿酸升高预示STEMI患者近、远期MACCE风险增加。

Objective To study the effect of serum uric acid（UA）level on long-term outcome in patients with acute ST-segment elevation myocardial infarction（STEMI）.Methods Three hundred and twenty-eight acute STEMI patients were divided into serum UA level≤290μmol/L group（group A,n=111）,serum UA level≤361μmo/L group（group B,n=109）and serum UA leve〉l361μmol/L group（group C,n=108）.The incidence of MACCE was compared during follow up.Results The mortality was 2.7%in group A,4.6%in group B,and 15.7%in group C（P=0.000）.The incidence of MACCE was 9.9%in group A,11.9%in group B and 27.8%in group C（P=0.001）.The patients were followed up for 42.3months,during which the incidence of MACCE was 4.3%in group A,11.1%in group B and 20.9%in group C（P=0.003）.Cox regression analysis showed that serum UA level was an independent predictor for MACCE.Conclusion Elevated serum UA level is an independent predictor for the short-and long-term outcomes in acute STEMI patients.