天津医药

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血清尿酸水平与冠状动脉病变程度的关系

黄晓英1,刘克强2,齐新2,贾文军3,赵春杰3,尹浩晔3   

  1. 1. 天津医科大学；天津市人民医院；心脏中心
    2. 天津市人民医院
    3.
  • 收稿日期:2009-12-09 修回日期:2010-02-08 出版日期:2010-05-15 发布日期:2010-05-15
  • 通讯作者: 黄晓英

Relationship between serum uric acid levels and the severity of angiographic coronary artery disease in patients with CAD

  • Received:2009-12-09 Revised:2010-02-08 Published:2010-05-15 Online:2010-05-15

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摘要： 目的：探讨冠状动脉造影患者血清尿酸(SUA)水平与冠状动脉病变程度的关系。方法：入院行冠状动脉造影患者474例，依冠状动脉造影结果确诊冠心病(CAD) 366例(77.22%)，非CAD患者108例(22.78%)。CAD诊断标准为冠状动脉造影显示≥1支冠状动脉狭窄部位管腔直径较临近正常部位管腔直径参考值≤50%。冠状动脉病变程度由冠状动脉病变支数和冠状动脉病变Gensini积分(GS)表示。高尿酸血症(HUA)标准：男性SUA>420μmol/L,女性SUA>357μmol/L。结果：1.CAD组SUA水平(317.40 90.14μmol/L)高于非CAD组(267.59 73.97μmol/L)(P<0.05)；性别分组后，女性CAD组SUA水平(293.87 79.88μmol/L)显著高于女性非CAD组(244.82 66.76 μmol/L)(P<0.05),男性CAD组SUA水平(324.96 92.06μmol/L)虽高于男性非CAD组(298.28 72.74 μmol/L)，但差异无显著性(P>0.05)；CAD组HUA百分比(21.9%)高于非CAD组(6.5%) (P<0.05)；性别分组后，女性CAD组HUA百分比(28.1%)高于女性非CAD组(6.5%)(P<0.05)，男性CAD组HUA百分比(19.9%)高于男性非CAD组(6.5%)(P<0.05)。2. CAD患病率在不同SUA四分位数组间有显著差异(P<0.05)，SUA水平处于第3四分位(86.6%)和第4四分位的CAD患病率(88.1%)明显高于第1四分位(65.3%)和第2四分位(68.9%)(P<0.05)。3.多因素Logistic回归分析显示HUA是冠状动脉造影诊断冠心病的独立危险因素(OR=2.639,95%CI 1.080～6.443,P=0.033)。4.Spearman秩相关分析提示SUA和GS间有正相关关系(r =0.270,P<0.01),亚组分析男性组、女性组SUA和GS间均有正相关关系(r=0.171,P<0.01；r=0.298, P<0.01)。结论：1.SUA可能是冠状动脉粥样硬化的独立危险因素。2.SUA和冠状动脉病变程度具有一定的相关性且女性相关性较男性略高。

关键词: 冠状动脉疾病, 动脉粥样硬化, 尿酸, 高尿酸血症, 冠状动脉血管造影, Gensini评分

Abstract: Objective To evaluate the relationship between serum uric acid(SUA) levels and the severity of angiographic coronary artery disease in patients with CAD. Methods 474 consecutive patients underwent coronary angiography were selected according to inclusion criteria. Of them, 366 cases were diagnosed as CAD, 108 cases were Non-CAD. Patient with the lumen diameter less than 50% at least in one vessel according to coronary Angiography were diagnosed as CAD. The severity of angiographic CAD was assessed by:1.the number of diseased vessels;2. the CAG Gensini score. The SUA level of men>420μmol/L or women>357μmol/L were diagnosed as hyperuricemia (HUA). Results 1.The SUA levels of CAD patients (317.40 90.14 μmol/L) were higher than those in Non-CAD patients (267.59 73.97μmol/L) (P<0.05).The SUA levels of female CAD patients (293.87 79.88μmol/L) were higher than those in female Non-CAD patients (244.82 66.76 μmol/L)(P<0.05).The SUA levels of male CAD patients (324.96 92.06 μmol/L) were higher than those in male Non-CAD patients (298.28 72.74 μmol/L) (P>0.05).The percentage of HUA in CAD patients(21.9%)were significantly higher than those in Non-CAD patients(6.5%)(P<0.05).The percentage of HUA both in male and female CAD patients(men 19.9%;women 28.1% )were significantly higher than those in male and female Non-CAD patients (6.5%)(P<0.05) respectively. 2.A significantly higher percentage of CAD patients had SUA concentrations in the range corresponding to quartile 3(86.6%) and 4(88.1%) than quartile 1(65.3%) and 2(68.9%)(P<0.05).3.Logistic regression analysis showed that HUA was an independent risk factor of CAD (OR=2.639, 95%CI: 1.080～6.443,P=0.033). 4.Significant Spearman’s correlations were found between the SUA level and Gensini score (r =0.270,P < 0.01).The same results were found in different genders( men: r =0.171, P<0.01;women :r =0.298, P<0.01). Conclusion 1. HUA could be an independent risk factor of coronary artery disease. 2. SUA level was correlated with the severity of CAD in patients with angiographic CAD. The relationship trends to be a little stronger in women than that in men.

Key words: coronary artery disease, atherosclerosis, uric acid, hyperuricemia, coronary Angiography, Gensini score