血尿酸与中老年冠心病患者冠状动脉支架内再狭窄的关系  

Relationship between serum uric acid and coronary in-stent restenosis in middle-aged and old patients with coronary heart disease

作　　者：谷臣锋 刘剑雄[2] 郑庆昆[2] 付秋玉[2] 黄晓波[2] 刘家勉[2] 

机构地区：[1]遵义医学院研究生院,贵州遵义563003 [2]遵义医学院附属成都市第二人民医院心内科

出　　处：《临床内科杂志》2017年第4期242-245,共4页Journal of Clinical Internal Medicine

摘　　要：目的 探讨血尿酸（SUA）与中老年冠心病（CHD）患者冠状动脉（冠脉）药物涂层支架（DES）植入术后支架内再狭窄（ISR）的关系.方法 根据术后复查冠脉造影（CAG）结果,将528例行DES植入的CHD患者分为ISR组（91例）和非ISR组（437例）.比较两组患者的临床资料,分析DES植入术后1年内发生ISR的相关因素.根据SUA水平将ISR组患者分为A、B、C、D组并比较其ISR程度.结果 ISR组和非ISR组患者术前吸烟、术后吸烟、CHD家族史、规律服药、SUA、胱抑素C（Cys-C）、总胆红素（TBIL）、冠脉三支病变、植入支架数量及支架直径比较,差异均有统计学意义（P〈0.05）;其余临床资料比较,差异均无统计学意义（P〉0.05）.多因素二元Logistic回归分析结果显示,较高的TBIL水平和规律服药是ISR的保护因素（P〈0.05）;术后吸烟、CHD家族史、支架直径较小、较高的SUA和Cys-C水平是ISR的危险因素（P〈0.05）.A、B、C、D组ISR程度分别为（53.06±6.45）%、（56.61±7.68）%、（72.52±15.60）%和（80.31±19.30）%,A、B组ISR程度分别与C、D组比较,差异均有统计学意义（P〈0.05）;A组ISR程度与B组比较,C组与D组比较,差异均无统计学意义（P〉0.05）.结论 SUA是ISR的独立危险因素,SUA水平越高,ISR程度越重,但两者之间不成线性递增关系.Objective To explore the relationship between serum uric acid（SUA） and in-stent restenosis（ISR） after coronary drug eluting stent（DES） implantation in middle-aged and old people with coronary heart disease（CHD）.Methods According to the results of coronary angiography（CAG） in following up,528 patients with coronary heart disease who received DES implantation were divided into ISR group（91 cases） and non-ISR group（437 cases）.Their clinical data were compared,then to analyze the risk factors of ISR after coronary DES implantation within one year.According to SUA,ISR patients were divided into group A,B,C,D and their degrees of ISR were compared.Results There were significant differences in preoperative and postoperative smoking,family history of CHD,regular drug taking,SUA,cystatin C（Cys-C）,total bilirubin（TBIL）,lesion of three vessels,number and diameter of stent between the two groups（P〈0.05）,but there were no significant differences in other clinical data between the two groups（P〉0.05）.Multivariate Logistic regression analysis of two variables showed that the higher level of TBIL and regular drug taking were protective factors for ISR（P〈0.05）,but postoperative smoking,family history of CHD,smaller diameter of stent,the higher level of SUA and Cys-C were risk factors for ISR（P〈0.05）.The degree of ISR in group A,B,C and D were（53.06±6.45）%,（56.61±7.68）%,（72.52±15.60）% and （80.31±19.30）% respectively.There were significant differences between group A,B and C,D respectively（P〈0.05）,but there were no significant differences between group A and B as well as group C and D（P〉0.05）.Conclusion SUA is the independent risk factor of ISR.The higher level of SUA leads to more serious ISR,but there is no linear growth relationship between them.

关 键 词：冠心病 药物涂层支架 支架内再狭窄 血尿酸 

分 类 号：R541.405[医药卫生—心血管疾病]