高尿酸血症对急性心肌梗死患者预后的影响

摘要/Abstract

摘要： 目的探讨高尿酸血症对急性心肌梗死（Acute Myocardial Infarction,AMI）患者冠脉狭窄程度、病情严重程度及行经皮冠状动脉介入治疗（Percutaneous coronary intervention,PCI）预后的影响。方法对2021年5月至2022年10月在该院心血管内科进行冠状动脉造影的298例病例数据进行回顾性分析,将其按相关检查结果分为三组,对临床数据在各组间的差异进行分析,并对血清尿酸（Serum uric acid,SUA）水平与冠状动脉病变程度之间的关系进行分析。在AMI组中利用是否诊断为高尿酸血症分为两亚组,分析高尿酸血症对其冠脉狭窄程度、病情严重程度及预后的影响。利用Logistic Regression分析AMI患者院内及院外主要心血管不良事件（Major adverse cardiovascular events,MACE）发生的危险因素。结果 AMI患者整体SUA水平较不稳定性心绞痛（Unstable angina pectoris,UA）及稳定性心绞痛（stable angina pectoris,SAP）患者明显升高（P<0.05）;所有患者的整体SUA水平与冠脉狭窄积分（Gensini）积分值呈正相关（r=0.171, P<0.05）,并且AMI患者Gensini积分值要远高于其他两组患者的积分值（P<0.05）;对于诊断为高尿酸血症的AMI患者Gensini积分值、Grace评分值及高危患者占比要明显高于非高尿酸血症的AMI患者（P<0.05）,并且其在院内及院外发生MACE的概率更高（P<0.05）;利用Logistic Regression分析证明了高尿酸血症是AMI患者院内及院外发生MACE的独立危险因素（P<0.05）。结论高尿酸血症会使AMI患者的冠脉狭窄程度更重、病情程度更重、疾病预后更差。

关键词: 高尿酸血症, 急性心肌梗死

Abstract: Objective To investigate the influenceof hyperuricemia on the severity of coronary stenosis anddisease conditions of patients with acute myocardial infarction (AMI)and their prognosis after percutaneous coronary intervention (PCI). Methods A retrospective analysis was performed for thedata of 298 patients who underwent coronary angiography in Department of Cardiovascular Medicine inour hospital from May 2021 to October 2022, and they were divided into three groups according to related examination results. Clinical data were compared betweenthe three groups, and the correlationbetween the level of serum uric acid(SUA)and the degree of coronary artery disease was analyzed. The AMI group was divided into two subgroups based on the diagnosis of hyperuricemia, and the influence of hyperuricemia on the degree of coronary stenosis, diseaseseverity, and prognosis wasanalyzed. Alogistic regression analysis was used to investigatethe risk factors formajor adverse cardiacevents (MACE) in and out of hospital inAMI patients. Results The patients withAMIhad a significantly higher level of SUA than those with unstable angina pectoris (UA) or stable angina pectoris (SAP)(P<0.05). SUA level was positively correlated with Gensini score for coronary stenosis in all patients(r = 0.171, P<0.05), and the patients withAMI had a significantly higher Gensini score than the other two groups (P<0.05). TheAMI patients diagnosed with hyperuricemia had significantly higher Gensini score, Grace score, and proportion of high-risk patients than those without hyperuricemia (P<0.05), with a significantly higher possibility of MACE in and out of hospital (P<0.05). The logistic regression analysis showed that hyperuricemia was an independent risk factor for MACE in and out of hospital in patients with AMI (P<0.05). Conclusion Hyperuricemia can increasethe severity of coronary stenosis and disease conditions and lead to a poorer prognosis of AMI patients.

Key words: Hyperuricemia, Acute myocardial infarction

李东阳, 郭阳, 杜犁, 王秋林. 高尿酸血症对急性心肌梗死患者预后的影响[J]. 心血管病防治知识, 2023, 13(17): 10-15.

LI Dong-yang, GUO Yang, DU Li, WANG Qiu-lin. Influence of hyperuricemia on the prognosis of patients with acute myocardial infarction[J]. Prevention and Treatment of Cardiovascular Disease, 2023, 13(17): 10-15.

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