老年冠心病患者中血尿酸对血管内皮功能紊乱的影响  

Serum uric acid and endothelial dysfunction in elderly coronary heart disease patients

作　　者：李红艳[1] 芦良花[1] 秦历杰[1] 王龙安[1] 

机构地区：[1]河南省人民医院急诊科,河南郑州450003

出　　处：《中国急救医学》2017年第5期446-449,共4页Chinese Journal of Critical Care Medicine

基　　金：河南省科技厅科技攻关项目（112102310234）

摘　　要：目的研究老年冠心病患者中血尿酸（UA）和血管内皮功能的关系。方法本研究采用前瞻性队列研究，搜集78例老年冠心病患者和78例健康老年人，对这些人群进行抽血化验血UA、血脂及超敏C-反应蛋白（hs—CRP），检测患者血压、体质量指数（BMI），同时采用超声无创血流介导的血管舒张功能（FMD）进行血管内皮功能评估，并进行统计学分析。结果冠心病患者血UA明显高于正常健康患者[（408．6±116．0）μmol／Lvs．（327．5±92．8）μmol／L，P=0．007]；血UA与FMD、hs—CRP存在显著线性相关（均P〈0．01）。FMD与年龄、BMI、血压、总胆固醇均无明显相关性。多元线性回归分析显示，血UA是FMD的独立决定因子（β=-0．237，P=0．036）。结论在老年冠心病患者中血UA与FMD显著相关。血UA可能通过损伤血管内皮功能促进冠心病的发生及发展。Objective To investigate the relationship of serum uric acid （UA） and endothelial dysfunction in elderly coronary heart disease patients. Methods In this prospective cohort study, the relationship of UA and endothelial dysfunction was investigated in 78 elderly coronary heart disease patients and 78 healthy patients. The clinical and laboratory data of blood UA, blood lipids and hs - CRP were collected. Patients＇ blood pressure and body mass index （BMI） were tested and recorded at the same time. Endothelial function was estimated by flow - mediated dilatation （FMD） of the brachial artery and expressed as percentage change relative to baseline diameter. Finally, we compared the difference between each group and analyzed the results with statistical methods. Results UA levels differed between 78 elderly coronary heart disease patients and 78 healthy patients [ （408.6 ±116.0 ） μmol/L vs. （ 327.5 ±92.8 ） μmol/L,P = 0. 007 ]. There were significant linear correlations between UA and FMD, hs - CRP, （ all P 〈 0.01 ）. There were no obvious correlations between FMD and age, BMI blood pressure, total cholesterol. Multivariate regression analysis showed that only UA was an independent determinant of FMD （ β =- 0. 237, P = 0. 036 ）. Conclusion There exists an independent correlation between UA and FMD, and higher UA level is related to worse endothelial function which may contribute to cardiovascular morbidity.

关 键 词：血尿酸(UA) 内皮功能 血流介导的血管舒张功能(FMD) 老年 冠心病 

分 类 号：R544.1[医药卫生—心血管疾病]