冠状动脉狭窄与血尿酸关系的分析

目的 了解冠状动脉不同狭窄程度患者的血尿酸水平,并分析二者之间的相关性.方法 1999年1月1日至2006年12月31日心内科住院所有患者均进行冠状动脉造影和血尿酸验测.以冠状动脉狭窄病变累及程度的不同,分成冠脉无病变组、冠脉1支病变组、2支病变组和3支病变组,进行方差分析,结合临床参数进行Kendall相关分析、Logistic回归分析.结果 2772例冠状动脉狭窄组血尿酸为(328±103) μmol/L,1031例冠状动脉无狭窄组为(314±98)μmol/L,差异有统计学意义(P＜0.01).冠状动脉狭窄与血尿酸、高血压病、糖尿病、吸烟、利尿药、血脂异常、肾功能、年龄、性别等单项临床参数均显著相关(r=0.051～0.271,均P＜0.01).血尿酸水平与上述各项临床参数(除年龄)也显著相关(r=0.030～0.203,均P＜0.05).3支病变组血尿酸(337±107)μmol/L高于无病变组(314±98)μmol/L、冠脉1、2支病变组[(318±99)μmol/L、328±104)μmol/L)],差异有统计学意义(P＜0.01).结论 冠状动脉狭窄与血尿酸水平显示独立相关,冠状动脉狭窄程度越重血尿酸水平越高.

Relationship between blood uric acid and degree of coronary artery stenosis

Objective To study the blood uric acid levels in the patients with or without coronary artery disease, as well as in the patients with different degrees of coronary artery stenosis, and to investigate the relationship between blood uric acid level and the degree of coronary artery stenosis. Methods 3803 patients who hospitalized frSom January 11999 to December 312006 underwent coronary angiography and uroxisome method to detect the blood uric acid. Results The age of the 2772 patients with coronary artery stenosis was (64±11 ), significantly elder than that of the 1031 patients without coronary artery stenosis [ (58±12), P＜0.01 ]. The percentage of males of the patients with coronary artery stenosis was 69.8%,significantly higher than that of the patients without coronary artery stenosis (50.5%, P＜0.01 ). The proportions of those with history of hypertension, diabetes, cerebral stroke, blood lipid abnormality,smoking, damaged renal function, and use of diuretics (all P＜0.01 ). The blood uric acid level of the patients with coronary artery stenosis was (328±103) μmol/L, not significantly different from that of the patients without coronary artery stenosis (314±98) μmol/L (P = 0. 009). Coronary artery stenosis was significantly correlated to all of the clinical parameters: blood uric acid, hypertension, diabetes, smoking,use of diuretics, blood lipid abnormality, damaged renal function, age and gender (all P＜0.001 ) , and blood uric acid level was significantly correlated with all the clinical parameters too ( all P＜0.05 ) , except age. Multivariable logistic regression showed that blood uric acid level was still independent predictors of coronary artery disease. The more extensive the coronary artery stenosis the higher the blood uric acid level (P＜0.001 ). Conclusion Coronary artery stenosis and blood uric acid level are independently relevant.The more extensive the coronary artery stenosis was, the higher the blood uric acid level was.