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冠状动脉事件后患者无症状高尿酸血症的意义。

Significance of asymptomatic hyperuricemia in patients after coronary events.

作者信息

Tasić Ivan, Kostić Svetlana, Stojanović Nikola M, Skakić Vlado, Cvetković Jovana, Djordjević Aleksandar, Karadzić Mirjana, Djordjević Dragan, Andonov Stanoje, Stoičkov Viktor, Tasić Dimitrije, Vanka Meenakshi, Lović Dragan

机构信息

a Department of Internal Medicine, Faculty of Medicine , University of Niš , Niš , Serbia.

b Institute for Therapy and Rehabilitation 'Niška Banja' , Niška Banja , Serbia.

出版信息

Scand J Clin Lab Invest. 2018 Jul;78(4):312-317. doi: 10.1080/00365513.2018.1467035. Epub 2018 Apr 27.

Abstract

The goal of the present study was to determine the prevalence of hyperuricemia in patients with coronary artery disease (CAD), within three months after coronary events. Also, we aimed to determine whether the presence of hyperuricemia holds correlation with severe CAD, overall heart functioning and risk factors for CAD. The study included 505 consecutive CAD patients, 385 males and 120 females, aged 60.9 ± 9.6 years, with a mean body mass index (BMI) 28.0 ± 3.7 kg/m. All patients were admitted to specialized cardiovascular rehabilitation within three months post-acute myocardial infarction (AMI) without revascularization (32.6%), percutaneous coronary intervention (PCI) with myocardial infarction (32.1%) and with coronary bypass graft (35.3%). The mean value of serum acidum uricum (SUA) was 345.5 ± 100.3 µmol/L, where 115 (22.8%) patients had asymptomatic hyperuricemia. Patients with asymptomatic hyperuricemia had significantly higher average number of risk factors, lower HDL cholesterol and higher creatinine and triglycerides levels, lower ejection fraction (EF). Multivariate stepwise analysis revealed that five parameters were capable to predict SUA levels. We can conclude that in patients with CAD, SUA levels are independently associated with BMI, triglyceride and creatinine levels and negatively with EF. Thus, one can say that asymptomatic hyperuricemia is not significantly associated with the severity of CAD.

摘要

本研究的目的是确定冠心病(CAD)患者在冠心病事件发生后三个月内高尿酸血症的患病率。此外,我们旨在确定高尿酸血症的存在是否与严重CAD、整体心脏功能以及CAD的危险因素相关。该研究纳入了505例连续的CAD患者,其中男性385例,女性120例,年龄60.9±9.6岁,平均体重指数(BMI)为28.0±3.7kg/m²。所有患者在急性心肌梗死(AMI)后三个月内入院接受专门的心血管康复治疗,其中未进行血运重建的患者占32.6%,接受经皮冠状动脉介入治疗(PCI)并伴有心肌梗死的患者占32.1%,接受冠状动脉搭桥术的患者占35.3%。血清尿酸(SUA)的平均值为345.5±100.3µmol/L,其中115例(22.8%)患者有无症状性高尿酸血症。无症状性高尿酸血症患者的平均危险因素数量显著更高,高密度脂蛋白胆固醇水平更低,肌酐和甘油三酯水平更高,射血分数(EF)更低。多因素逐步分析显示,有五个参数能够预测SUA水平。我们可以得出结论,在CAD患者中,SUA水平与BMI、甘油三酯和肌酐水平独立相关,与EF呈负相关。因此,可以说无症状性高尿酸血症与CAD的严重程度无显著关联。

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