苏州地区老年高尿酸血症患者发生急性心肌梗死的临床特征及危险因素  

Clinical characteristics and risk factors of acute myocardial infarction in elderly patients with hyperuricemia in Suzhou

作　　者：李恒涛 郑光华[1] 李庚 汤卫兵 LI Hengtao;ZHENG Guanghua;LI Geng;TANG Weibing(Department of Emergency Medicine,Suzhou Jiulong Hospital,School of Medicine,Shanghai Jiao Tong University,Suzhou,Jiangsu 215028,China)

机构地区：[1]上海交通大学医学院苏州九龙医院急诊内科,江苏苏州215028

出　　处：《公共卫生与预防医学》2023年第5期91-94,共4页Journal of Public Health and Preventive Medicine

基　　金：苏州市科技发展计划(民生科技-医疗卫生应用基础研究)项目(SYSD2018064)。

摘　　要：目的 分析苏州地区老年高尿酸血症(hyperuricemia, HUA)患者发生急性心肌梗死(acute myocardial, AMI)的临床特征及危险因素,为HUA患者防治AMI提供理论依据。方法 选取2016年1月至2021年12月苏州九龙医院收治的≥60岁HUA患者356例,根据患者是否并发AMI分为对照组和AMI组,从病历系统收集患者临床资料,统计HUA患者发生AMI类型及冠状动脉的3支主要血管病变情况,对比两组血清BNP水平和LVEF值,采用单因素分析和logistic回归分析HUA患者发生AMI的危险因素。结果 356例HUA患者发生AMI 55例(15.45%),其中NSTEMI患者26例(47.27%),STEMI患者29例(52.73%);3支病变30例(54.55%);与对照组相比,AMI组患者男性比例、平均年龄、吸烟史比例、收缩压、FPG、LDL-C、Hcy水平、血UA、血BNP水平明显增高(P<0.05),而LVEF值出现降低(P<0.05)。吸烟史(OR=2.987)、LDL-C高(OR=3.439)、Hcy高(OR=2.672)、FPG高(OR=3.874)是HUA患者发生AMI的危险因素(P<0.05)。结论 苏州地区HUA患者发生AMI的风险较高,多为STEMI患者,具有病变支数多等特点,对于有吸烟史、Hcy、LDL-C、FPG控制不佳的HUA患者发生AMI的风险较大,应积极戒烟、控制LDL-C、Hcy、FPG水平,可降低发生AMI的风险。Objective To analyze the clinical characteristics and risk factors of(acute myocardial infarction,AMI)in elderly patients with(hyperuricemia,HUA)in Suzhou,and to provide a theoretical basis for the prevention and treatment of AMI in patients with HUA.Methods Among of 356 patients with hyperuricemia aged≥60 years who were admitted to Suzhou Jiulong Hospital from January 2016 to December 2021 were selected.The patients were divided into control group and AMI group according to whether they were complicated with AMI.The clinical data of the patients were collected from the medical record system,and the types of AMI and the lesions of the three main coronary vessels in patients with HUA were statistically analyzed.The serum BNP level and LVEF value of the two groups were compared.Univariate analysis and logistic regression analysis were conducted to analyze the risk factors of AMI in patients with HUA.Results Fifty-five cases(15.45%)of 356 patients with HUA developed AMI,including 31 males and 24 females.There were 26 patients(47.27%)with NSTEMI and 29 patients(52.73%)with STEMI.In addition,30 cases(54.55%)had three-vessel lesions.Compared with the control group,the male ratio,average age,smoking history ratio,systolic blood pressure,FPG,LDL-C and Hcy levels in the AMI group were significantly increased(P<0.05),while LVEF values decreased(P<0.05).Smoking history(OR=2.987),high LDL-C(OR=3.439),high Hcy(OR=2.672)and high FPG(OR=3.874)were risk factors for AMI in patients with HUA(P<0.05).Conclusion HUA patients in Suzhou area have a high risk of AMI,and most of them are STEMI patients,with the characteristics of multi vessel branch lesions.For HUA patients with smoking history,poor control of Hcy,LDL-C and FPG,the risk of AMI is higher.Smoking cessation and control of LDL-C,Hcy and FPG levels should be actively adopted to reduce the risk of AMI.

关 键 词：老年高尿酸血症患者 急性心肌梗死 临床特征 

分 类 号：R181[医药卫生—流行病学]