不同性别血尿酸水平与冠心病的相关性  

Association of Serum Uric Acid Level with Coronary Heart Disease in Men and Women

作　　者：李晨怡[1] 陈佳[1] 施向凡[1] LI Chenyi;CHEN Jia;SHI Xiangfan(Department of Medical Care for Cadres,Zhejiang Hospital,Hangzhou 310012,China)

机构地区：[1]浙江医院干部保健科,杭州310012

出　　处：《中国医学科学院学报》2018年第3期338-343,共6页Acta Academiae Medicinae Sinicae

基　　金：浙江省医药卫生科技计划项目(201346767)~~

摘　　要：目的探讨不同性别人群中血尿酸(SUA)水平与冠心病及冠状动脉狭窄程度的相关性。方法以2013年6月至2017年6月在浙江医院心内科接受冠状动脉造影检查的760例患者为研究对象,根据冠状动脉造影结果计算Gensini积分,检测SUA水平,根据SUA四分位水平分组,分析不同性别患者SUA水平与冠心病患病率及Gensini积分间的关系。结果在女性患者中,冠心病组与非冠心病组患者的SUA水平差异有统计学意义(t=4.415,P=0.000),单因素Logistic回归分析结果显示,SUA为冠心病的独立危险因素(OR=1.32,95%CI:1.12~1.58,P=0.002);1、2、3、4分位组的冠心病患病率分别为31.2%、52.6%、47.4%和59.7%(χ~2=13.652,P=0.003),2(P=0.007)、3(P=0.038)、4分位组(P=0.000)的冠心病患病率均显著高于1分位组;在女性冠心病患者中,4组在靶血管数(Z=4.627,P=0.008)、病变血管支数(χ~2=18.522,P=0.005)和Gensini积分(Z=3.683,P=0.029)方面差异均有统计学意义,4分位组的Gensini积分显著高于1(P=0.012)和2分位组(P=0.014);多元线性回归分析结果显示,Gensini积分的升高与SUA水平的升高存在剂量-反应关系(B=1.105,SE=0.365,P=0.003)。在男性患者中,冠心病组与非冠心病组患者的SUA水平差异无统计学意义(t=1.271,P=0.205);1、2、3、4分位组的冠心病患病率分别为77.9%、69.0%、61.7%、79.6%,差异无统计学意义(χ~2=4.514,P=0.211)。结论 SUA是女性冠心病患者的独立危险因素。SUA水平越高,女性冠状动脉狭窄程度越严重。男性中未见这种相关性。Objective To explore the relationship between serum uric acid（ SUA） level and coronary heart disease（ CHD） in male and female patients. Methods A total of 760 hospitalized patients undergoing coronary angiography in our department from June 2013 to June 2017 were enrolled. Gensini score was calculated according to the result of coronary angiography,and SUA was tested. Patients were divided according to SUA quartiles. The relationship between SUA level and the prevalence of CHD in male and female patients was analyzed. Results Among females,there was significant difference in SUA level between patients with and without CHD（ t = 4. 415,P = 0. 000）. Univariate logistic regression analysis showed that SUA level was independently associated with CHD（ OR = 1. 32,95% CI： 1. 12-1. 58,P = 0. 002）. The prevalence of CHD was 31. 2%,52. 6%,47. 4%,and 59. 7%,respectively,in four quartile groups（ χ~2= 13. 652,P = 0. 003）; in addition,female patients displayed significantly higher prevalence of CHD in the quartile 2（ P = 0. 007）,3（ P = 0. 038）,and 4（ P = 0. 000） groups than in quartile 1 group. Among female patients with CHD,there were significant differences in number of target vessels（ Z = 4. 627,P = 0. 008）,number of lesion vessels（ χ~2= 18. 522,P =0. 005）,and Gensini score（ Z = 3. 683,P = 0. 029） in four groups. The Gensini scores of coronary artery were significantly higher in the quartile 4 group than in quartile 1（ P = 0. 012） and 2（ P = 0. 014） groups. Multiple linear regression analysis showed that there was a dose-response relationship between SUA level and Gensini score（B = 1. 105,SE = 0. 365,P = 0. 003）. Among males,however,there was no significant difference in SUA level between patients with and without CHD（ t = 1. 271,P = 0. 205）. The prevalence of CHD in four quartile groups was 77. 9%,69. 0%,61. 7%, and 79. 6%, respectively, showing no significant difference（ χ~2=4. 514,P = 0. 211）. Conclusions SUA is an independent risk fact for female CHD pa

关 键 词：冠心病 GENSINI积分 血尿酸 

分 类 号：R514.4[医药卫生—内科学]