老年冠心病行PCI术合并高尿酸血症患者血小板聚集功能临床特点

The feature of clinic and platelet aggregation in coronary heart disease patients undergoing PCI with hyperuricemia

目的 探讨老年冠心病行PCI术合并高尿酸血症患者血小板聚集功能临床特点.方法 选取武汉大学人民医院2012年6月至2015年6月行冠状动脉造影诊断为冠心病行PCI术,且年龄＞60岁的患者297例,根据是否合并高尿酸血症分为高尿酸血症组（试验组,n=138例）和非高尿酸血症组（对照组,n=159例）.统计并比较两组患者基本临床资料及入院尿酸、血小板聚集率等实验室检查结果.结果 两组患者基本临床资料、药物使用情况比较未见统计学差异（P＞0.05）,具有可比性.试验组术前及术后6个月血小板聚集率（43.63±4.59比40.85±5.12,38.78±5.07比36.98±4.47）及血小板高反应性发生比率（24.6％比13.2％,18.1％比6.3％）显著高于对照组,差异有统计学意义（P＜0.05）;尿酸水平与血小板聚集率呈正相关（r=0.470,P＜0.01）;Logistic回归分析表明高尿酸血症为HPR的危险因素（P＜0.05）.结论 老年冠心病行PCI术患者合并高尿酸血症患者血小板聚集率显著升高,且血尿酸水平与血小板聚集率呈正相关.

Objective To explore the feature of clinic and platelet aggregation in coronary heart disease patients undergoing PCI with hyperuricemia. Methods 297 patients aged more than 60 years old were diagnosed CHD by coronary angiogarphy and successfully undergoing PCI from June 2012 to June 2015 in our hospital. Patients were divided into observation group（ 138 cases ） or control group（ 159 cases） according to whether combined with hyperuricemia. The Basic clinical data and laboratory results including uric acid, platelet aggregation within 24 h were collected compared in the two group. Results The basic clinical data, laboratory results, therapeutic of drugs, had no statistical significance between two group （P〉0.05）. Compared with control group, the level of PA （43.63±4.59 vs 40.85±5.12, 38.78±5.07 vs 36.98±4.47）and incidence of HPR （24.6% vs 13.2% ,18.1% vs 6.3%） in observation group was higher than that of control group（P〈0.05） before and 6 months after the operation. The positive correlations of uric acid with platelet aggregation were significant in all patients （r=0.470, P〈0.01 ）. The logistic analysis showed that hyperuricemia may be the independent predictors of HPR （P〈0.05）. Conclusion Patients of CHD combined with hyperuricemia have higher level of platelet aggregation, besides, the level of uric acid and platelet aggregation rate were positively correlated.