秋水仙碱对肾功能正常的痛风患者冠心病的一级预防  

Colchicine for the Primary Prevention of Coronary Artery Disease in Patients With Gout and Normal Renal Function

作　　者：李萌玫 宋玲[2] 孙洪巧 滕军 刘为生 LI Mengmei;SONG Ling;SUN Hongqiao;TENG Jun;LIU Weisheng(Department of Emergency/Chest Pain Center,Qingdao Central Hospital,Qingdao Shandong 266042,China;Department of Outpatient,Qingdao Municipal Hospital,Qingdao Shandong 266071,China)

机构地区：[1]青岛市中心医院急救中心/胸痛中心,山东青岛266042 [2]青岛市市立医院门诊部,山东青岛266071

出　　处：《中国卫生标准管理》2023年第17期114-118,共5页China Health Standard Management

摘　　要：目的 确定秋水仙碱是否对肾功能正常的痛风患者冠心病一级预防有效。方法 2022年1月—2023年1月回顾性分析青岛市中心医院、青岛市市立医院肾功能正常的痛风患者,选取188例开始应用秋水仙碱时无冠心病患者入组。根据秋水仙碱使用史分为秋水仙碱组(n=88)与非秋水仙碱组(n=100)。比较基线特征,并使用Cox比例风险模型确定冠心病与秋水仙碱应用之间的关系,同时统计秋水仙碱与不良心血管事件(MACE事件)的关系。冠心病定义为运动负荷试验或血管造影确诊为冠心病。结果 治疗后随访的中位时间为3.9年。秋水仙碱组总冠心病发病率低于非秋水仙碱组,但差异无统计学意义(3.7%vs.12.4%,P> 0.05),而秋水仙碱组运动负荷试验阳性和冠脉造影阳性人数低于非秋水仙碱组,差异无统计学意义(2.5%vs.6.7%;1.2%vs.7.9%,P> 0.05)。秋水仙碱组MACE事件发生率低于非秋水仙碱组,差异有统计学意义(2.5%vs.12.4%,P <0.05)。结论 秋水仙碱可能对肾功能正常的痛风患者的冠心病初级预防并无明显优势,但可以降低MACE事件的风险。由于本研究为回顾性研究,样本量较小、时间跨度较短,需要长期、大型的前瞻性临床试验来证明初级预防的有效性。文章中体现了《中国心血管病一级预防指南》的临床参考。Objective This study aimed to determine whether colchicine reduces the incidence of coronary heart disease in gouty patients with normal renal function.Methods From January 2022 to January 2023,the study retrospectively studied gout patients(n=188) with normal renal function of Qingdao Central Hospital,Qingdao Municipal Hospital.According to the history of colchicine use,they were divided into the colchicine group(n=88) and the non-colchicine group(n=100).Baseline characteristics were compared,and Cox proportional hazards models were used to determine the relationship between coronary heart disease and colchicine use,and the relationship between colchicine and major adverse cardiovascular events(MACE) was also statistically analyzed.Coronary heart disease was defined as coronary heart disease confirmed by exercise stress test or angiography.Results A retrospective study of these patients was performed for a median of 3.9 years.The incidence of total coronary artery disease in the colchicine group was lower than that in the non-colchicine group,and the difference was not statistically significant(3.7% vs.12.4%,P>0.05),while the number of positive exercise stress tests and positive coronary angiography was lower in the colchicine group than the non-colchicine group,the difference was not statistically significant(2.5% vs.6.7%;1.2% vs.7.9%,P>0.05),the incidence of MACE events in the colchicine group was lower than that in the non-colchicine group,The difference between the two was statistic ally significant(2.5%vs.12.4%,P<0.05).Conclusion Colchicine has no obvious advantage for the primary prevention of coronary artery disease in gouty patients with normal renal function,but it was effective in reducing the risk of MACE events.Since this study is a retrospective study with small sample size and a short time,we still need long-term,large-scale prospective clinical trials to prove the effectiveness of primary prevention.

关 键 词：冠状动脉疾病 秋水仙碱 一级预防 急性心肌梗死 回顾性队列研究 痛风 

分 类 号：R589[医药卫生—内分泌]