冠心病合并2型糖尿病患者血清尿酸水平与经皮冠状动脉介入治疗术后再狭窄的关系

Relationship between serum uric acid level and post-PCI restenosis in coronary artery disease patients accompanied by type 2 diabetes mellitus

目的 探讨冠心病合并 2型糖尿病患者血清尿酸 (UA)水平与经皮冠状动脉介入治疗 (PCI)术后再狭窄严重程度的相关性。方法 对 91例曾接受经皮冠状动脉腔内成形术 (PTCA)及支架置入术的冠心病合并 2型糖尿病患者测定血清UA及其他临床生化指标。根据 6个月后冠状动脉造影复查的结果 ,分为再狭窄组(37例 )和对照组 (5 4例 )进行回顾性分析。结果 再狭窄组的血清UA水平为 (495 .2 1± 10 3.5 5 )mmol/L ,明显高于对照组的 (434 .5 5± 94.6 2 )mmol/L(P <0 .0 0 1)。再狭窄组内的亚组分析显示 ,急性心肌梗死组和心绞痛组的血清UA水平分别为 (5 2 0 .18± 12 3.33)mmol/L和 (5 31.46± 91.72 )mmol/L ,均明显高于陈旧性心肌梗死组的 (44 1.92± 78.43)mmol/L(P值均 <0 .0 5 )。多因素逐步回归分析显示 ,冠心病合并 2型糖尿病患者支架内再狭窄程度积分与血清UA水平间存在显著线性回归关系 (P <0 .0 0 1)。结论 血清UA水平与冠心病合并 2型糖尿病患者PCI术后再狭窄程度密切相关。

Objective To investigate the correlation between serum uric acid level and post-PCI restenosis in coronary heart disease patients accompanied by type 2 diabetes mellitus.Methods The serum uric acid level and other clinical biochemical parameters were measured in 91 coronary artery disease patients accompanied by type 2 diabetes mellitus who had undergone percutaenous coronary interventions. According to the results after six-month follow-up,the data of 37 in the restenosis group and 54 in the control group were reviewed and analyzed retrospectively. Results The level of serum uric acid was significantly higher in the restenosis group than that in the control group [( 495.21 ±103.55) mmol/L vs ( 434.55 ±94.62) mmol/L, P <0.001]. Analysis of subgroups in the restenosis group also indicated that serum uric acid level was higher in recent acute myocardial infarction subgroup and angina pectoris subgroup than that in old myocardial infarction subgroup [( 520.18 ±123.33) mmol/L vs ( 441.92 ±78.43) mmol/L, P =0.027;( 531.46 ±91.72) mmol/L vs ( 441.92 ±78.43) mmol/L , P =0.011].Using stepwise regression analysis ,a linear regression relationship was found between serum levels of uric acid, blood glucose two hour after meal, total cholesterol and in-stent restenosis score in coronary artery disease patients with type 2 diabetes(P<0.001).Conclusion Serum uric acid level is strongly correlated with the degree of post-PCI restenosis in coronary heart disease patients accompanied by type 2 diabetes. Whether lowering of serum uric acid level can lead to alleviation of post- PCI restenosis remains to be revealed by further prospective study.