新发心肌梗死与血清尿酸水平的关系  

Relationship between acute myocardial infarction and level of serum uric acid

作　　者：张清云[1] 周芸玲[1] 罗迦[2] 邹兰[1] 罗卉[1] 肖莲[1] 

机构地区：[1]四川省广元市第二人民医院心内科,广元市628017 [2]四川省广元市中心医院心内科,广元市628001

出　　处：《中国循证心血管医学杂志》2016年第1期94-96,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的探讨新发心肌梗死与血清尿酸水平之间的关系。方法选取2009年2月-2014年12月于四川省广元市第二人民医院治疗的急性心肌梗死患者280例（AMI组）,其中男性166例,女性114例,年龄23-75岁,平均年龄（56.39±12.93）岁。同时选取在心内科住院的非急性心肌梗死患者100例作为对照组,其中男性59例,女性41例,年龄26-69岁,平均年龄（55.10±14.41）岁。所有心肌梗死患者于6 h内行冠状动脉造影,明确相关梗死血管,结合心电图表现,分为单病灶组（178例）和多病灶组（102例）。所有入选者检测血清尿酸、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、总胆固醇（TC）及三酰甘油（TG）。同时测定胸痛发作后12 h的肌酸激酶同工酶（CK-MB）。测量左室舒张末期内径（LVEDD）,Simpson法测量左室射血分数（LVEF）。结果 AMI组血清尿酸为（352.18±65.20）mmol/L,明显高于对照组（301.37±72.08）mmol/L,差异有统计学意义（P〈0.01）。与单病灶组比较,多病灶组血清尿酸[（322.17±69.40）mmol/L vs.（374.38±54.39）mmol/L]、CK-MB[（40.32±18.41）U/L vs.（75.50±20.27）U/L]、LVEDD[（47.53±6.39）mm vs.（54.30±5.13）mm]升高,LVEF[（61.27±7.18）%vs.（41.94±8.54）%]降低,差异有统计学意义（P均〈0.01）。两组血脂水平比较,差异无统计学意义（P均〉0.05）。相关性分析显示,急性心肌梗死患者血清尿酸与CK-MB呈正相关（r=0.589,P〈0.05）,与LVEF呈负相关（r=-0.605,P〈0.05）,与LVEDD无相关性（P〉0.05）。结论新发心肌梗死患者血清尿酸水平升高,同时血清尿酸水平越高心功能越差,心肌损伤越严重。Objective To investigate the relationship between acute myocardial infarction（AMI） and level of serum uric acid（UA）. Methods AMI patients（n=280, male 166, female 114, aged from 23 to 75 and average age=56.39±12.93） were chosen from Feb. 2009 to Dec. 2014 as AMI group, and non-AMI patients（n=100, male 59, female 41, aged from 26 to 69 and averaged age=55.10±14.41） were chosen as control group at the same time. All AMI patients were given coronary angiography（CAG） within 6 h for determining infarction vessels, and then divided into single-focus group（n=178） and multi-focus group（n=102） based on outcomes of electrocardiogram（ECG）. The levels of serum UA, low-density lipoprotein-cholesterol（LDL-C）, high-density lipoprotein-cholesterol（HDL-C）, total cholesterol（TC） and triglyceride（TG） were detected, and meanwhile creatine kinase MB（CK-MB） was detected after chest pain attack for 12 h. The changes of left ventricular end-diastolic inner diameter（LVEDd） were detected, and left ventricular ejection fraction（LVEF） was detected by using Simpson＇s method. ResultsThe level of serum UA was（352.18±65.20） mmol/L and（301.37±72.08） mmol/L in control group（P〈0.01）. The levels of serum UA [（322.17±69.40） mmol/L vs.（374.38±54.39） mmol/L], CK-MB [（40.32±18.41） U/L vs.（75.50±20.27） U/L], LVEDd [（47.53±6.39） mm vs.（54.30±5.13） mm] increased, and LVEF [（61.27±7.18）% vs.（41.94±8.54）%] decreased in multi-focus group compared with multi-focus group（all P〈0.01）. The difference in level of blood fat had no statistical significance（all P〉0.05）. The correlation analysis showed that serum UA was positively correlated to CK-MB（r=0.589, P〈0.05）, negatively correlated to LVEF（r=-0.605, P〈0.05） and not correlated to LVEDd（P〉0.05）. Conclusion The level of serum UA increases in patient with AMI, and myocardial injury will be more serious as increase of serum UA level and decrease of heart function.

关 键 词：急性心肌梗死 血尿酸 心功能 相关性 

分 类 号：R542.22[医药卫生—心血管疾病]