血尿酸水平对2型糖尿病合并冠状动脉性心脏病患者不良心血管事件发生的预测价值  

The value of serum uric acid levels for predicting major adverse cardiovascular events in patients with type 2 diabetes mellitus complicated by coronary artery heart disease

作　　者：王前[1] 王翼华[1] 孙富强[2] WANG Qian;WANG Yihua;SUN Fuqiang(Department of Endocrinology,Nanyang First People′s Hospital,Nanyang 473000,Henan Province,China;Department of Cardiology,Nanyang First People′s Hospital,Nanyang 473000,Henan Province,China)

机构地区：[1]南阳市第一人民医院内分泌科,河南南阳473000 [2]南阳市第一人民医院心内科,河南南阳473000

出　　处：《新乡医学院学报》2025年第3期192-196,共5页Journal of Xinxiang Medical University

基　　金：河南省医学科技攻关计划项目(编号:2018020977)。

摘　　要：目的探讨血尿酸水平对2型糖尿病(T2DM)合并冠状动脉性心脏病(CHD)患者主要不良心血管事件(MACE)发生的预测价值。方法选择2022年5月至2024年5月南阳市第一人民医院收治的150例T2DM患者为研究对象,依据是否合并CHD将患者分为T2DM组(n=70)和T2DM合并CHD组(n=80)。选择同期于本院进行健康体检者70例为对照组。收集T2DM合并CHD患者的性别、年龄、病程、体质量指数(BMI)、吸烟史、饮酒史、高血压、使用胰岛素、使用他汀类药物情况、病变支数等临床资料;采用尿酸酶过氧化物酶偶联法检测血尿酸水平,免疫投射比浊法检测D-二聚体(D-D)、纤维蛋白原(FIB)水平。通过电话和门诊进行随访1 a,统计T2DM合并CHD患者MACE发生情况。根据是否发生MACE将T2DM合并CHD患者分为无MACE组和MACE组,比较2组患者的临床资料,采用logistic回归分析T2DM合并CHD患者MACE发生的危险因素,受试者操作特征(ROC)曲线分析血尿酸对T2DM合并CHD患者MACE发生的预测价值。结果T2DM组和T2DM合并CHD患者血尿酸水平显著高于对照组(t=4.790、6.430,P<0.05);T2DM合并CHD患者血尿酸水平显著高于T2DM组(t=1.400,P<0.05)。无MACE组与MACE组患者的性别、年龄、病程、BMI、吸烟史、饮酒史、高血压、使用胰岛素、使用他汀类药物情况比较差异无统计学意义(P>0.05)。无MACE组与MACE组患者的病变支数及D-D、FIB、血尿酸水平比较差异有统计学意义(P<0.05)。Logistic回归分析结果显示,病变支数≥2、高D-D、高FIB及高血尿酸水平是T2DM合并CHD患者MACE发生的危险因素(P<0.05)。ROC曲线分析结果显示,D-D预测T2DM合并CHD患者MACE发生的曲线下面积(AUC)为0.679,FIB预测T2DM合并CHD患者MACE发生的AUC为0.680,病变支数预测T2DM合并CHD患者MACE发生的AUC为0.734,血尿酸预测T2DM合并CHD患者MACE发生的AUC为0.815,血尿酸预测T2DM合并CHD患者MACE发生的AUC显著高于D-D、FIB、病变支数(P<0.05)。Objective To explore the value of the serum uric acid level for predicting major adverse cardiovascular events(MACEs)in patients with type 2 diabetes mellitus(T2DM)and coronary heart disease(CHD).Methods A total of 150 T2DM patients admitted to Nanyang First People′s Hospital from May 2022 to May 2024 were selected and divided into a T2DM group(n=70)and a T2DM+CHD group(n=80)based on whether they were complicated by CHD or not.Another 70 individuals who underwent health examinations at our hospital during the same period were selected as the control group.Clinical data such as gender,age,disease duration,body mass index(BMI),smoking history,alcohol consumption history,hypertension,insulin use,statin use,and lesion count were collected from T2DM patients with CHD.Serum uric acid levels were detected by the uricase peroxidase coupling method,and D-dimer(D-D)and fibrinogen(FIB)levels were measured by immunoturbidimetry.The patients were followed up for 1 year through telephone and outpatient visits,and the occurrence of MACEs in T2DM patients with CHD was recorded.T2DM patients with CHD were further divided into a non-MACE group and an MACE group according to whether MACEs occurred.Their clinical data were compared,and the risk factors for MACE occurrence in T2DM patients with CHD were analyzed by logistic regression.The value of serum uric acid levels for predicting MACE occurrence in T2DM patients with CHD was assessed with the receiver operator characteristics(ROC)curve.Results Serum uric acid levels in T2DM and T2DM+CHD groups were significantly higher than those in the control group(t=4.790,6.430;P<0.05).Serum uric acid levels in the T2DM+CHD group were significantly higher than those in the T2DM group(t=1.400,P<0.05).There was no statistically significant difference in gender,age,disease duration,BMI,smoking history,alcohol consumption history,hypertension,insulin use,and statin use between non-MACE and MACE groups(P>0.05).There were statistically significant differences in the number of lesion branches,seru

关 键 词：2型糖尿病 冠状动脉性心脏病 血尿酸 主要不良心血管事件 

分 类 号：R541.4[医药卫生—心血管疾病] R587.1[医药卫生—内科学]