高尿酸血症与择期冠状动脉介入治疗术后短期预后之间的关系  

Relationship between hyperuricemia and short-term prognosis after selective coronary intervention

作　　者：蓝明[1] 刘兵[1] 何青[1] Lan Ming;Liu Bing;He Qing(Department of Cardiology,Beijing Hospital,National Geriatrics Center,Beijing 100730,China)

机构地区：[1]北京医院心内科国家老年医学中心,100730

出　　处：《中华保健医学杂志》2020年第3期140-143,共4页Chinese Journal of Health Care and Medicine

基　　金：北京市科学技术委员会“首都临床特色应用研究”专项资助课题(Z181100001718138)。

摘　　要：目的评估高尿酸血症(hyperuricemia,HUA)与择期冠状动脉介入治疗(percutaneous coronary intervention,PCI术后短期预后的关系。方法回顾性分析北京医院2013年9月~2017年9月期间行择期PCI患者的资料。高尿酸血症诊断标准定义为血尿酸水平男性> 420 umol/L(7 mg/d1),女性> 357 umol/L(6 mg/d1),将患者分为高尿酸组和正常尿酸组。主要不良心脏事件(major adverse cardiac events,MACE)包括死亡,心肌梗死和靶血管再血管化治疗。收集患者住院期间资料信息,比较两组患者PCI术后院内主要不良心脏事件的差异。数据分析采用χ~2检验,各变量之间的相关性采用logistic回归分析,统计结果的显著性水平均选为0.05。结果共纳入2 654例患者,其中HUA组571人,非HUA组2 083人。HUA组与非HUA组相比冠状动脉血管单支病变的比例更低,而双支病变及三支病变的比例更高(单支病变:24.3%vs. 35.3%,双支病变:30.6%vs. 28.0%,三支病变:45.0%vs. 36.7%,P <0.001);经logistic回归分析,调整了传统冠心病危险因素后,HUA与PCI术后的主要不良心脏事件独立相关(OR=1.309,95%CI:1.066~1.607,P=0.010),其中HUA与PCI术后院内心肌梗死独立相关(OR=1.349,95%CI:1.097~1.659,P=0.005),HUA与PCI术后院内靶血管再血管化(OR=1.681,95%CI:0.562~5.022,P=0.353)及死亡(OR=0.361,95%CI:0.031~4.194,P=0.415)不独立相关。结论 HUA是择期PCI术后院内主要不良心脏事件及院内心肌梗死的独立危险因素。Objective The purpose of this study was to evaluate the relationship between hyperuricemia(HUA)and shortterm prognosis after selective percutaneous coronary intervention(PCI).Methods We performed a retrospective cohort study of the patients with selective PCI from September 2013 to September 2017.HUA was defined as>7 mg/dL(>420 mmol/L)in men and>6 mg/dL(>357 mmol/L)in women,and the patients were divided into HUA group and non-HUA group.Major adverse cardiac events(MACE)include death,myocardial infarction,and target vessel revascularization(TVR).We collected the data and information of patients during hospitalization period and compared the difference of MACE between the two groups after PCI.Results A total of 2654 patients were enrolled,including 571 in the HUA group and 2083 in the non-HUA group.The proportion of single vessel disease was lower in the HUA group than that in the non-HUA group,while the proportion of two vessel disease and three vessel disease was higher in the HUA group(single vessel disease:24.3%vs.35.3%,two vessel disease:30.6%vs.28.0%,three vessel disease:45.0%vs.36.7%,P<0.001).Multivariate logistic regression analysis was performed and adjusted for traditional risk factors of CAD.After multivariate logistic regression analysis was performed,there was independent correlation between HUA and MACE after PCI(OR=1.309,95%CI:1.066~1.607,P=0.010),and there was an independent correlation between HUA and myocardial infarction after PCI during hospitalization(OR=1.349,95%CI:1.097~1.659,P=0.005),however this independent correlation was not found between HUA and TVR(OR=1.681,95%CI:0.562~5.022,P=0.353)or death(OR=0.361,95%CI:0.031~4.194,P=0.415).Conclusion HUA is an independent risk factor for MACE and myocardial infarction during hospitalization after PCI.

关 键 词：高尿酸血症 冠状动脉介入治疗 短期预后 病变支数 

分 类 号：R541[医药卫生—心血管疾病]