摘要
目的:探讨老年患者血浆同型半胱氨酸(Hcy)及尿酸水平与冠心病危险程度之间的关系。方法:回顾828例因胸痛来我院就诊行冠状动脉造影的老年患者(年龄>65岁),根据冠状动脉造影分为A组(非冠心病组)、B组(冠心病组),冠心病组再根据症状、心肌酶学及心电图变化分为B1组(稳定性冠心病组)、B2组(不稳定型心绞痛组)、B3组(急性心肌梗死组)。比较四组间Hcy、尿酸水平及其发病率的关系,以及Hcy、尿酸水平与急性心肌梗死的相关性。结果:(1)与A组比较,B组血浆Hcy及尿酸水平明显升高,差异有统计学意义(P<0.001,P=0.004);(2)血浆Hcy水平A组与B2组、A组与B3组、B2组与B3组比较,差异均有统计学意义(P<0.05);血浆尿酸水平A组与B2组、A组与B3组比较,差异均有统计学意义(P<0.05)。(3)高Hcy血症的发生率,B2及B3组较A组明显升高(P<0.001),在B组中,B2及B3较B1组也明显升高(P<0.001),差异均有统计学意义;高尿酸血症发生率,B3组较A组明显升高,差异有统计学意义(P=0.002)。(4)患者血浆尿酸水平与Hcy水平呈正相关(标准化回归系数=0.116,P=0.007)。(5)血浆Hcy水平是急性心肌梗死的独立危险因素(OR=1.681,95%CI:1.03~2.73,P=0.012)。结论:高Hcy血症及高尿酸血症与老年患者急性心肌梗死有关。
Objective： To investigate the association of homocysteine and uric acid levels withcoronary events in elderly patients. Methods： A total of 828 elderly patients with chest distress,who underwent coronary angiography were enroll in the study. Patients were divided into groups with normal coronaries group（ group A）and CAD group（ group B） based on coronary angiography. CAD group（ group B） was divided into groups with stable angina pectoris group（ group B1）,unstable angina pectoris group（ group B2）,acute myocardial infarction group（ group B3） based on symptoms,myocardial enzyme markers and ECG. The homocysteine and uric acid levels of group A,group B1,group B2,group B3 were analyzed. Results：（1） Compared with the level of homocysteine and uric acid in group A,those in group B were significant higher（ homocysteine： P〈0. 001,uric acid： P = 0. 004）.（2）Compared with the level of homocysteine in group A and B1,that in group B2 was significant higher; well,the level of uric acid in group B3 was significant higher than the latter one（ P〈0. 05）.Compared with the level of uric acid in group A and B1,that in group B2 and B3 were significant higher（ P〈0. 05）.（3）Compared with the hyperhomocysteinemia in group A,that was in group B2 and B3 were significant higher（ P〈0. 001）; well compared with the hyperhomocysteinemia in group B1,that was in group B2 and B3 were significant higher（ P〈0. 001）. Compared with the hyperuricemia in group A,that was in group B3 was siginificant higher（ P = 0. 002）.（4） The level of uric acid was linearly associated with homocysteine（ Standarizedβ = 0. 166,P = 0. 007）.（5）The level of homocysteine remained a significant predictor of acute myocardial infarction after adjusting for sex,diabetes,smoking and history of CAD（ OR = 1. 681,95% CI： 1. 03-2. 73,P= 0. 012）. Conclusion： In elderly patients,hyperhomocysteinemia and hyperuricemia are associated with the acute myocardial infarction,the level of homocyste
作者
汪蕾
蔡濛
张萍
WANG Lei CAI Meng ZHANG Ping(Department of Geriatric,Belting Jishuitan Hospital, Beijing 100035, China)
出处
《心肺血管病杂志》
2017年第8期629-632,637,共5页
Journal of Cardiovascular and Pulmonary Diseases
关键词
高同型半胱氨酸血症
高尿酸血症
冠心病
急性心肌梗死
老年人
Hyperhomocysteinemia
Hyperuricemia
Coronary artery disease
Acute myocardial infarction
Elderly patient
