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高尿酸血症与冠脉造影确诊的冠心病的相关性

张晶1,李广平2,王伟1,3,陈孟英1,3   

  1. 1. 天津市胸科医院
    2. 天津医科大学第二医院心脏科
    3.
  • 收稿日期:2010-11-05 修回日期:2011-01-20 出版日期:2011-04-15 发布日期:2011-04-15
  • 通讯作者: 张晶

The Relation of Hyperuricemia with the Presence and Severity of Angiographic Coronary Artery Disease

  • Received:2010-11-05 Revised:2011-01-20 Published:2011-04-15 Online:2011-04-15
  • Contact: Jing ZHANG

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摘要： 目的：探讨高尿酸血症（HUA）与冠脉造影确诊的冠心病（CAD）的发生及严重程度的相关性。方法：对647例接受冠脉造影的患者测定各项临床指标，根据冠脉造影结果分为冠心病组和对照组，以发生病变的血管支数及Gensini积分为冠心病严重程度的度量, 分性别进行对照研究。结果：（1）女性冠心病组的HUA比例高于与对照组（P<0.01）。（2）HUA与冠心病发生的相关性只对女性有统计意义(OR = 2.022，95%CI: 1.098~3.723，P =0.023)，但在对年龄进行调整后，这种相关性没有统计意义(OR = 1.513，95%CI: 0.778~2.931，P=0.221)。对两性患有HUA都不是冠心病发生的独立危险因素。（3）对两个性别的冠心病组，病变血管支数的分布在HUA患者与非HUA患者之间均无有统计意义的差异（P=0.57；P=0.30）。女性HUA患者的Gensini积分高于非HUA患者（P=0.04），且在女性的全组、HUA组及非HUA组上Gensini积分均与血尿酸水平正相关（r= 0.181，P = 0.004；r= 0.291，P = 0.049；r= 0.138，P = 0.046）。结论: 女性HUA与冠心病的发生有一定关联，但不是独立危险因素。临床诊断中似应重视高龄女性HUA患者发生冠心病的危险。

关键词: 冠心病, 血尿酸, 高尿酸血症, 冠脉造影, 危险因素

Abstract: Objective: To evaluate the association between hyperuricemia (HUA) and the presence and severity of angiographic coronary artery disease (CAD). Methods: The study group consisted of 647 consecutive patients undergone coronary angiography. The anthropometric measurements including serum uric acid for every patient were conducted. According to the results of angiography, the patients with or CAD were divided into two groups. The severity of CAD was measured in terms of the number of vessels with disease and Gensini score. Results: (1) In women, the HUA percentage was significantly higher in CAD patients than in non-CAD patients (P<0.01). (2) HUA was significantly associated with the presence of CAD only in women (OR = 2.022，95%CI: 1.098~3.723，P =0.023). However, after adjusting for age, the association was no longer significant (OR = 1.513，95%CI: 0.778~2.931，P=0.221). HUA was not an independent risk factor of CAD in both genders. (3) For both genders, the relation between HUA and the distribution of diseased vessel numbers was not significant in the CAD patients (P=0.57；P=0.30). For women the Gensini score was significantly higher in HUA patients than in non-HUA patients（P=0.04, and the rank correlation was found to be significant in the total, HUA and non-HUA groups （r= 0.181，P = 0.004；r= 0.291，P = 0.049；r= 0.138，P = 0.046） . Conclusion: In women, HUA was associated with CAD with statistic significance, but was not an independent risk factor for CAD. Particular attention should be paid in aged woman HUA patients in clinical CAD diagnosis.

Key words: coronary artery disease, serium uric acid, hyperuricemia, coronary angiography, risk factor