| 尿酸与急性ST段抬高型心肌梗死患者急诊PCI术后冠脉血流及预后的相关性研究 |
| 投稿时间：2014-06-24 修订日期：2014-08-19 点此下载全文 |
| 引用本文：高鹏,张舸,黄慧贤.尿酸与急性ST段抬高型心肌梗死患者急诊PCI术后冠脉血流及预后的相关性研究[J].医学研究杂志,2015,44(2):104-108 |
| DOI：
10.3969/j.issn.1673-548X.2015.02.029 |
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| 中文摘要:目的 研究住院期间尿酸水平与急性ST段抬高型心肌梗死(STEMI)患者急诊经皮冠脉介入(PCI)术后冠脉血流以及预后的相关性。方法 选取2010年1月~2013年6月就诊于海淀医院STEMI患者, 根据尿酸水平, 将STEMI患者分为高尿酸组(男性>420μmol/L, 女性>360μmol/L)和正常尿酸组(男性≤420μmol/L, 女性≤360μmol/L)。多变量分析住院期间尿酸水平与STEMI患者急诊PCI术后冠脉血流受损相关性以及尿酸水平与STEMI患者死亡和主要不良心血管事件的相关性。结果 高尿酸组无复流(TIMI血流0、1、2级)发生率显著高于正常尿酸组(29.0% vs 10.2%, P<0.05)。高尿酸组住院期间、6个月主要不良心血管事件显著高于正常尿酸组(分别25.8% vs 7.4%, P<0.05;25.2% vs 23.1%, P<0.05)。多变量分析表明, 在校正了影响因素后, 尿酸与STEMI患者急诊PCI术后冠脉血流受损、住院期间不良心血管事件的独立相关(分别OR=1.09, 95%CI:1.02~1.18, P<0.05;OR=1.09, 95%CI:1.02~1.12, P<0.05)。结论 住院期间尿酸升高是STEMI患者急诊PCI术后冠脉血流受损和短期不良预后独立预测因子。因此, 作为一项简便、快捷、低廉、可靠的检查手段, 尿酸不但能预测STEMI患者急诊PCI术后冠脉血流受损, 还是评估STEMI患者危险分层有效的标志物。 |
| 中文关键词:尿酸 急性ST段抬高型心肌梗死 急诊PCI 临床预后 |
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| Association of Uric Acid with Coronary Flow and Prognosis in ST-segment Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention |
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| Abstract:Objective To study the effects of admission SUA level on coronary blood flow and prognosis in ST-Segment elevation myocardial infarction(STEMI) patients undergoing primary percutaneous coronary intervention(PCI). Methods All patients that were consecutively treated at Hai Dian hospital from January 2010 to June 2013, with the diagnosis of STEMI were enrolled the study. All Patients were divided into two groups based on the admission uric acid level: elevated uric acid group(>420μmol/L in men, >360μmol/L in women);normal SUA group(≤420μmol/L in men, ≤360μmol/L in women).Multivariate analyses were used to examine the association of uric acid with coronary flow and mortality and MACEs in ST-Segment elevation myocardial infarction patients undergoing primary PCI. Results Patients with elevated uric acid group had a significant higher prevalence of no-reflow(TIMI grade 0, 1, 2flow) on angiography compared with the normal uric acid group(29.0% vs 10.2%, P<0.05).The high uric acid group had significant higher in- hospital and six-month prevalence of MACEs (25.8% vs 7.4%, P<0.05;25.2% vs 23.1%, P<0.05 respectively).In a multivariate analyses, when adjusted for mixed factors, uric acid on admission independently risk associated with impaired coronary blood flow following primary PCI and in-hospital MACEs among patients with STEMI(OR=1.09, 95%CI:1.02~1.18, P<0.05;OR=1.09, 95%CI:1.02~1.12, P<0.05, respectively). Conclusion Elevated uric acid on admission is an independent risk factor of impaired coronary blood flow and short-term poor prognosis following primary PCI.As a simple, quick, cheap, available assessed biomarker, uric acid not only is strongly predictive for impaired coronary flow following primary PCI, but also is a useful biomarker for stratification of risk in patients with STEMI. |
| keywords:Uric acid ST-segment elevation myocardial infarction Primary percutaneous coronary intervention Prognosis |
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