【摘要】 目的探讨血尿酸(SUA)水平在合并高尿酸血症患者的急性心肌梗死(AMI)和不稳定型心绞痛(UAP)的差异性,并分析SUA与心肌肌钙蛋白I(cTnI)的相关性。方法共纳入190例AMI患者(AMI组)和186例UAP患者(UAP组),根据SUA水平将AMI和UAP患者分别分为高尿酸血症亚组和正常尿酸亚组,分组比较SUA水平和cTnI水平在AMI和UAP患者中的差异性,并通过Spearman相关分析SUA水平与cTnI水平的相关性,logistics多因素回归分析影响高尿酸血症患者SUA水平的独立因素。结果 AMI患者高尿酸血症亚组的中位SUA水平明显高于UAP患者高尿酸血症亚组(P<0.01);AMI患者正常尿酸亚组中位SUA水平与UAP患者正常尿酸亚组无统计学差异(P>0.05)。AMI患者高尿酸血症亚组和正常尿酸亚组的中位cTnI水平均高于UAP患者的相应亚组(P<0.01),但AMI患者高尿酸血症亚组和正常尿酸亚组之间,UAP患者高尿酸血症亚组与正常尿酸亚组之间,差异均无统计学意义(均P>0.05)。Spearman相关系数分析显示,在高尿酸血症患者中,SUA水平与cTnI水平呈正相关(r=0.349,P<0.05);而在正常尿酸患者中,SUA水平与cTnI水平呈负相关(r=-0.301,P<0.05)。cTnI水平和年龄与高尿酸血症患者的SUA水平独立相关(均P<0.01)。结论 SUA水平能够用于区分合并高尿酸血症的AMI和UAP患者,可作为非特异性参数用于评估合并高尿酸血症的急性冠脉综合征患者的心肌损伤程度。更多还原

【Abstract】 Objective To investigate the difference of serum uric acid(SUA) level between acute myocardial infarction(AMI) and unstable angina pectoris(UAP) in patients with hyperuricemia, and to analyze the correlation between SUA and cardiac troponin I(cTnI).Methods One hundred and ninety patients with AMI and 186 patients with UAP were enrolled. Patients with AMI and UAP were divided into hyperuricemia subgroup and normal uric acid subgroup according to SUA level. The difference of cTnI level in patients with AMI and UAP, and the correlation between SUA level and cTnI level was analyzed by Spearman correlation coefficient. Logistic multivariate regression analysis was used to analyze the independent factors of SUA level in patients with hyperuricemia. Results The m edian SUA level in the hyperuricemia subgroup of patients with AMI was significantly higher than that in the hyperuricemia subgroup with UAP(P <0.01). The median SUA level in the normal uric acid subgroup of patients with AMI had no significant difference with the normal uric acid subgroup with UAP(P >0.05). The median cTnI level in the hyperuricemia subgroup and the normal uric acid subgroup of patients with AMI was higher than that of the corresponding subgroup with UAP(P<0.01), but there was no significant difference between the hyperuricemia subgroup and the normal uric acid subgroup with AMI, or between the hyperuricemia subgroup and the normal uric acid subgroup with UAP(both P >0.05). Spearman correlation coefficient analysis showed that there was a positive correlation between SUA level and cTnI level in patients with hyperuricemia(r=0.349, P<0.05). In patients with normal uric acid, SUA level was negatively correlated with cTnI level(r=-0.301, P<0.05).The cTnI level and age were independently associated with SUA levels in patients with hyperuricemia(all P<0.01). Conclusion SUA levels can be used to distinguish between patients with AMI and UAP with hyperuricemia, and can be used as non-specific parameters to assess the degree of myocardial damage in patients with acute coronary syndrome with hyperuricemia.更多还原