不同性别老年高尿酸血症与冠状动脉病变程度的相关性研究  

Study on the correlation between hyperuricemia and severity of coronary artery lesions in different sex elderly patients

作　　者：吴琳[1] 陈素欣[1] 吕新湖[1] 刘星[1] 

机构地区：[1]河北省石家庄市第一医院心内科,050011

出　　处：《河北医药》2016年第10期1491-1493,1497,共4页Hebei Medical Journal

基　　金：石家庄市科学技术研究与发展计划项目(编号:131452503)

摘　　要：目的探讨不同性别老年高尿酸血症（HUA）与冠脉病变程度的关系。方法回顾性分析436例老年行冠脉造影患者,根据冠状动脉造影结果分为两组,冠心病组270例,非冠心病组（对照组）166例,观察2组吸烟、高血压病、2型糖尿病、高脂血症、冠心病家族史、体重指数及高尿酸血症与冠心病发病的关系。再将患者按血尿酸浓度男性〉420μmol/L,女性〉357μmol/L的标准诊断高尿酸血症分为HUA组与非HUA组,观察HUA与冠脉病变支数及冠脉狭窄程度（Gensini）积分的关系。结果老年冠心病组血尿酸水平高于对照组,差异有统计学意义（P〈0.05）。HUA为老年冠心病发生的影响因素,对其他指标进行校正采用多因素Logisitic回归进行危险因素筛选,HUA是老年女性冠心病发生的独立危险因素[OR=2.141,95%CI（1.072~3.132）,P〈0.05]。老年女性病变血管支数的分布在HUA组与非HUA组之间差异有统计学意义（Z=2.79,P〈0.05）。老年女性HUA患者的Gemini积分高于非HUA患者（Z=2.12,P〈0.05）。老年男性病变血管支数的分布在HUA组与非HUA组之间差异无统计学意义（Z=3.86,P〉0.05）。老年男性HUA患者的Gesini积分与非HUA患者差异无统计学意义（Z=3.37,P〉0.05）。结论老年女性HUA是冠心病独立危险因素。老年男性HUA与冠心病发生有一定关联,但不是独立危险因素,HUA可以说是反应冠心病疾病程度的关键生化指标。冠心病诊治方面,一定要高度重视老年高尿酸血症。Objective To investigate the correlation between hyperuricemia（ HUA） and severity of coronary artery lesions in different sex elderly patients. Methods The data about 436 elderly patients who underwent coronary angiography were retrospectively analyzed. These patients were divided into two groups according to the examination results by coronary angiography： coronary heart disease group（ CHD group,n = 270）,non- CHD group（ control group,n = 166）. The correlation between smoking,hypertension,type 2 diabetes,hyperlipidemia,family history of CHD,body mass index,hyperuricemia and the pathogenesis of CHD was observed and compared between two groups. Then these patients were redivided into HUA group and non- HUA group according to blood uric acid concentrations in men 420 mol / L,in women 357 mol / L,moreover,the correlation between HUA and coronary lesion blood vessel numbers as well as stenosis degree of coronary artery（ Gensini integral） was analyzed. Results The levels of uric acid in blood of CHD group were significantly higher than those in control group（ 401. 79 ＋ 82. 63 vs 367. 65 ＋ 74. 29,P〈0. 05）. The HUA was an important influencing factor of the pathogenesis of senile CHD,moreover,HUA was an independent risk factor of pathogenesis of CHD in elderly women（ OR = 2. 141,95% CI（ 1. 072 ~ 3. 132）,P〈0. 05）. There was a significant difference in the distribution of lesion blood vessels in elderly females between HUA group and non- HUA group（ Z = 2. 79,P〈0. 05）. The Gemini integral in elderly female patients with HUA was significantly higher than that in non HUA patients（ Z = 2. 12,P〈0. 05）.There was no significant difference in the distribution of lesion vessels in elderly males between the HUA group and non- HUA group（ Z = 3. 86,P〈0. 05）. There was no significant difference in Gemini integral in elderly males between HUA group and non- HUA group（ Z = 3. 37,P〈0. 05）. Conclusion HUA is an independent risk factor of CHD in elderly women.HUA is correlated to

关 键 词：高尿酸血症 冠心病 冠状动脉狭窄程度 性别 

分 类 号：R725.414[医药卫生—儿科]