冠心病合并2型糖尿病患者药物洗脱支架置入术后尿酸水平与支架内再狭窄的关联性研究  

Analyse the serum uric acid significantly associated with the occurrence of in-stent restenosis in patients with diabetes mellitus following coronary stenting with drug-eluting stent

作　　者：王建龙[1] 王志坚[1] 史冬梅[1] 刘宇杨[1] 赵迎新[1] 杨丽霞[1] 成万钧[1] 周玉杰[1] WANG Jianlong;WANG Zhijian;SHI Dongmei;LIU Yuyang;ZHAO Yingxin;YANG Lixia;CHENG Wanjun;ZHOU Yujie(Department of 12^th Ward, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029, China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所心内科,100029

出　　处：《心肺血管病杂志》2018年第5期398-401,共4页Journal of Cardiovascular and Pulmonary Diseases

基　　金：北京市医院管理局临床医学发展专项经费(ZYLX201303);北京市医院管理局"登峰"计划专项经费(DFL20150601);北京市医院管理局临床医学发展专项经费(ZYLX201303;XMLX201601);国家临床重点专科建设项目经费(2013-2014年度)

摘　　要：目的:探讨冠心病合并2型糖尿病患者经皮冠状动脉介入术(PCI)后,UA水平与冠状动脉支架内再狭窄(ISR)的关联性。方法:连续入选2012年1月至2012年12月,在我中心行PCI术的冠心病合并糖尿病患者共437例,进行2年的随访,最终共有368例,完成了第二次PCI并符合该研究的纳入和排除标准进入统计分析。结果:368例患者(男性108例,女性260例),平均年龄(58.71±10.25)岁,其中有74例发生了ISR,发生率为20.1%。多因素回归分析结果显示,在调整了传统危险因素和其他混杂因素后,UA每增加50μmol/L,糖尿病患者ISR的风险增加19%(HR=1.19,95%CI:1.05~1.34,P=0.006)。结论:血尿酸水平是冠状动脉ISR的危险因素,可以作为临床预测并预防冠心病合并糖尿病患者冠状动脉ISR的指标之一。Objective： The aim of the study was to investigate the UA significantly associated with the occurrence of in-stent restenosis(ISR） in diabetic patients following coronary stenting with drug-eluting stent(DES）. Methods： A total of 437 patients with diabetes who diagnosed DM and underwent coronary DES implantation at Department of 1 th Ward,Beijing Anzhen Hospital in China were consecutively enrolled from Junuary 2012 to December 2012. Finally,368 of these patients who met the inclusion and exclusion criteria were followed up by angiography after baseline PCI. Results： A total of 368 patients(260 women and 108 men）with a mean ages of(58. 71 ± 10. 25） years were enrolled in this study. Angiography result showed that ISR occurred in 74/368 CAD patients(20. 1%）. In the multivariate Cox＇s proportional hazards regression,after adjusting for traditional risk factors,lipid profiles,angiographic factors,medical history,and other biomarkers,the HR for the occurrence of ISR associated with UA level(per 50 μmol/L increments）,the HR was 1. 19(95% CI = 1. 05-1. 34,P = 0. 006）. Conclusion： The higher higher serum UA levels was independent predictor of ISR in DM patients after coronary DES implantation. It provided new evidence for physicians to take measures to lower the risk of ISR for the better management after PCI.

关 键 词：冠心病 糖尿病 支架内再狭窄 尿酸 

分 类 号：R54[医药卫生—心血管疾病]