眼底动脉硬化、尿酸、同型半胱氨酸与冠心病的相关性研究  

Correlation between fundus arteriosclerosis,uric acid,homocysteine and coronary heart disease

作　　者：刘湘君 崔冬梅 李洪银 张燕[3] 张晗 张小敏 郭娟 Liu Xiangjun;Cui Dongmei;Li Hongyin;Zhang Yan;Zhang Han;Zhang Xiaomin;Guo Juan(Heart Center,The First Hospital of Tsinghua University,Beijing 100016,China)

机构地区：[1]清华大学第一附属医院心脏中心,北京100016 [2]清华大学第一附属医院眼科,北京100016 [3]中国中医科学院眼科医院目系眼病科

出　　处：《北京医学》2021年第3期215-219,共5页Beijing Medical Journal

基　　金：首都卫生发展科研专项(2016-4-4182)。

摘　　要：目的探讨尿酸、同型半胱氨酸、眼底动脉硬化与冠心病的相关性。方法选取2019年10—12月清华大学第一附属医院行冠状动脉造影检查诊断为冠心病的患者90例,同期选择住院或门诊排除冠心病的患者102例作为对照组。所有患者均行眼底镜检查,进行常规生化指标的收集,冠心病组根据冠状动脉造影结果行Gensini评分,评估冠状动脉病变狭窄的严重程度。比较两组眼底检查结果与Gensini评分的相关性,尿酸、同型半胱氨酸与Gensini评分的相关性。结果冠心病组BMI、尿酸、同型半胱氨酸、高脂血症比例及舒张压高于对照组,差异有统计学意义(P<0.05)。眼底动脉硬化程度、尿酸、同型半胱氨酸与冠心病Gensini评分呈正相关(r=0.649,P<0.01;r=0.400,P<0.01;r=0.310,P<0.05)。多因素logistic回归分析显示,眼底动脉硬化分级、同型半胱氨酸、高脂血症与冠心病独立相关(P<0.05)。结论眼底动脉硬化程度、同型半胱氨酸水平、高脂血症与冠心病独立相关;尿酸水平与冠心病呈正相关,但不是冠心病的独立危险因素。Objective To explore the correlation between fundus arteriosclerosis,uric acid,homocysteine and coronary heart disease(CHD).Methods Ninety patients with CHD from October to December 2019 in The First Hospital of Tsinghua University were enrolled in the CHD group.CHD was confirmed by coronary angiography before or during the current hospitalization.One hundred and two patients in the control group were inpatients or outpatients without CHD during the same period.All the patients had ophthalmoscope examination and biochemistry.Gensini scores were calculated in the CHD group based on coronary angiography results to assess the severity of coronary artery disease stenosis.The difference of fundoscopic examination results between the CHD group and the control group was compared.The correlations between fundus arteriosclerosis,uric acid,homocysteine and Gensini score for CHD were analyzed.Results BMI,uric acid and homocysteine,DBP and the proportion of hyperlipemia were significantly higher in the CHD group than those in the control group(P<0.05).Fundus arteriosclerosis severity,uric acid,homocysteine were positively correlated with the Gensini score(r=0.649,P<0.01;r=0.400,P<0.01;r=0.310,P<0.05).Multivariate logistic regression analysis showed that the grade of ocular fundus arteriosclerosis,homocysteine and hyperlipidemia were independently associated with CHD.Conclusions The grade of ocular fundus arteriosclerosis,the level of homocysteine and hyperlipidemia are independently correlated with CHD,while the level of uric acid is positively correlated with CHD,but it is not an independent risk factor for CHD.

关 键 词：眼底动脉硬化 尿酸 同型半胱氨酸 冠心病 

分 类 号：R541.4[医药卫生—心血管疾病]