45岁以下青年发生急性冠脉综合征的影响因素

Influencing Factors of Acute Coronary Syndrome in Young People under 45 Years Old

目的:探讨血尿酸(UA)水平对45岁以下急性冠状动脉综合征(ACS)患者的临床意义。方法:选择2020年1月—2022年1月福建医科大学附属泉州第一医院收治的因“胸闷、胸痛”入院的可疑ACS患者224例为研究对象,根据诊断分为ACS组与非ACS组,比较两组UA及其他指标的差异,运用Logistic回归法筛选ACS的主要危险因素;经KruslalWallis秩和检验分析冠状动脉病变支数与尿酸水平相关性。结果:ACS组吸烟、饮酒、高血压、高脂血症、UA、总胆固醇、低密度脂蛋白胆固醇及Gensini积分明显高于非ACS组,差异有统计学意义(P<0.05);而两组血小板、血小板分布宽度、甘油三酯、高密度脂蛋白胆固醇、尿素氮、肌酐比较,差异无统计学意义(P>0.05)。Logistic回归分析结果显示高尿酸是发生ACS的重要危险因素;秩和检验显示,冠状动脉病变支数越多,尿酸水平越高,差异有统计学意义(Z=12.872,P<0.001)。结论:高尿酸血症是青年ACS重要危险因素,冠状动脉病变支数与尿酸的呈中等强度相关,可为临床治疗提供参考。

Objective:To explore the clinical significance of serum uric acid(UA)level in patients with acute coronary syndrome(ACS)under 45 years old.Methods:Two hundred and twenty-four patients with suspected ACS admitted to Quanzhou First Hospital Affiliated to Fujian Medical University from January 2020 to January 2022 due to"chest tightness and pain"were selected as the research objects.According to the diagnosis,they were divided into ACS group and non-ACS group.The differences in UA and other indicators were compared between the two groups,and the main risk factors of ACS were screened by Logistic regression.The Kruslal-Wallis rank sum test was used to analyze the correlation between the number of coronary artery lesions and the level of uric acid.Results:The smoking,drinking,hypertension,hyperlipidemia,UA,total cholesterol,low-density lipoprotein cholesterol and Gensini scores in the ACS group were significantly higher than those in the non-ACS group,and the difference was statistically significant(P<0.05).There was no significant difference in platelets,platelet distribution width,triglycerides,high-density lipoprotein cholesterol,blood urea nitrogen,and creatinine between the two groups(P>0.05).Logistic regression analysis showed that high uric acid was an important risk factor for ACS.The rank sum test showed that the more the number of coronary artery lesions,the higher the uric acid level,and the difference was statistically significant(Z=12.872,P<0.001).Conclusion:Hyperuricemia is an important risk factor for ACS in young people,and the number of coronary artery disease is moderately correlated with uric acid,which can provide reference for clinical treatment.