无症状高尿酸血症与陈旧性心肌梗死预后的关系

The relationship between asymptomatic hyperuricemia and the prognosis in the patients of old myocardial infarction

目的探讨无症状高尿酸血症与陈旧性心肌梗死患者预后的关系。方法顺序收集陈旧性心肌梗死患者81例,分为陈旧性心肌梗死组（OMI组）与陈旧性心肌梗死伴无症状高尿酸血症组（OMI伴无症状HUA组）,平均随访（16.09±5.06）个月。通过Kaplan-Meier生存曲线及COX回归,分析无症状高尿酸血症与陈旧性心肌梗死患者预后的关系。结果 （1）随访期间共发生心血管终点事件29例,发生率为35.8%。（2）OMI组与OMI伴无症状HUA组比较左室射血分数、GFR差异具有统计学意义。（3）经Kaplan-Meier生存曲线分析示：OMI伴无症状HUA组心血管终点事件发生率明显高于OMI组。（4）COX回归分析显示：COX回归单因素分析显示,以心血管事件为终点时,风险比例（HR）为2.36（95%CI 1.12~5.01,P〈0.05）,多因素COX回归分析调整年龄、吸烟、高血压、糖尿病等后,风险比例（HR）为2.50（95%CI 0.18~0.89,P〈0.05）。结论无症状高尿酸血症与陈旧性心肌梗死患者预后密切相关,无症状高尿酸血症是预测OMI患者心血管终点事件的危险因素。

Objective To explore the relationship between asymptomatic hyperuricemia and the prognosis in the patients with old myocardial infarction. Methods 81 cases of old myocardial infarction were divided into old myocardial infarction（ OMI group） and old myocardial infarction with asymptomatic hyperuricemia group（ OMI with asymptomatic HUA group）,mean follow-up time was 16. 09 ± 5. 06 months,the relationship of asymptomatic hyperuricemia and the prognosis in the patients with old myocardial infarction was analyzed by Kaplan-Meier survival curves and COX regression. Results1. The total cardiovascular endpoint events occurred in 29 cases during follow-up,the rate was 35. 8%. 2. The differences of LVEF,GFR in OMI group and OMI with asymptomatic HUA group were statistically significant. 3. Kaplan-Meier survival curve analysis showed that the cardiovascular event incidence rates in OMI with asymptomatic HUA group were significantly higher than that in OMI group. 4. COX regression analysis showed：COX regression univariate analysis showed that when at the end point of cardiovascular events,the proportion of hazard ratio（ HR） was 2. 36（95% CI1. 12-5. 01,P 0. 05）,multivariate COX regression analysis after adjusted for age,smoking,hypertension,diabetes,HR was 2. 50（ 95% CI 0. 18-0. 89,P 0. 05）. Conclusion Asymptomatic hyperuricemia is closely related with the prognosis in patients with old myocardial infarction and is a risk factors forecasting cardiovascular endpoint events in patients with OMI.