血清尿酸在疑似冠心病患者中的临床价值评估

目的 探讨血清尿酸（SUA）在疑似冠心病（CAD）患者中的临床价值.方法 选取行冠脉造影检查者229 例作为研究对象,根据冠脉病变支数分为无冠心病组和冠心病组,比较各组血清尿酸浓度和其他相关指标.结果 161 例患者有冠心病,冠心病组患者SUA 浓度明显高于无冠心病组.SUA 和冠心病严重程度显著相关.校正年龄、糖尿病、吸烟、血胆固醇和代谢综合征这些混杂因素后发现,SUA 不是冠心病的独立危险因素.亚组分析表明,SUA 和女性冠心病患者明显相关.与第一四分位数（〈4.8mg/dL）相比,SUA 在最高四分位数（≥6.4 mg/dL）显示为CAD 的风险增加（OR ,1.88;95% CI ,0.91-3.84）,然而,这-结果的差异并不显著（P = 0.075）.多元回归分析表明,代谢综合征（MS）是唯一的独立SUA 水平决定因素,而前者和冠心病相关.结论 血清尿酸不是冠心病的独立危险因素,而仅仅是胰岛素抵抗的一个标志.

Clinical Value of Serum Uric Acid in Patients with Suspected Coronary Artery Disease

Objective To explore the clinical value of serum uric acid （SUA）in patients with coronary artery disease （CAD）. Methods There were 229 consecutive patients with suspected CAD who had undergone coronary angiography.Patients were divid- ed into non CAD group or CAD group according to the results of coronary artery stenosis.The serum uric acid level and other pa- rameters were compared between two groups.Results There were 161 patients with CAD.SUA was higher in patients with CADcompared with cases without CAD （5.5 mg/dL±1.0 mg/dL vs.5.2 mg/dL±1.0 mg/dL,P = 0.004）.SUA was associated with signif- icantly severity of CAD （P = 0.002）.After adjusting for significant confounding factors including age,diabetes,smoking,cholesterol, and metabolic syndrome （MS）,SUA was not an independent risk factor of CAD （P = 0.151）.Based on a subgroup analysis,SUAwas more closely associated with CAD in women than in men,and in the highest quartile （≥6.4 mg/dL）than in the first quartile （〈 4.8 mg/dL）.however,these results were not significant （P = 0.062,P = 0.075,respectively）.In multivariate regression analysis, the most important determinant of SUA was MS,which was strongly associated with CAD.Conclusions In patients with suspectedCAD,SUA is not an independent risk factor for CAD and it may be merely a marker of insulin resistance.