摘要
目的:利用光学相干断层扫描技术(OCT)研究血尿酸水平与薄纤维帽粥样硬化斑块(TCFA)之间的相关性。方法:入选2015-01-2018-02在新疆医科大学第一附属医院心脏中心住院治疗的冠心病患者129例。所有患者均经冠状动脉造影术确诊,采用OCT测定冠状动脉粥样硬化斑块参数。采用多重线性回归的统计方法分析血清尿酸水平与TCFA的关系。结果:①基于OCT结果将129例患者分为非TCFA组(96例)和TCFA组(33例),在单因素分析中,两组患者的性别、吸烟、2型糖尿病、体质指数(BMI)、肾小球滤过率(eGFR)、尿酸、低密度脂蛋白胆固醇(LDL-C)等比较,差异有统计学意义(P<0.05);在多因素logistic回归分析中,吸烟、2型糖尿病、LDL-C、尿酸为TCFA的影响因素(分别为P=0.016、P=0.007、P=0.005、P=0.025),且为TCFA发生的预测因子,其中血尿酸是其独立危险因素(OR=1.007,95%CI:1.001～1.014,P=0.025);②根据血尿酸水平将患者分为高尿酸(>420μmol/L)组(27例)与低尿酸(<420μmol/L)组(102例),两组在纤维帽厚度、脂质弧、巨噬细胞评级、斑块破裂、血栓方面均差异有统计学意义(分别为P<0.001、P=0.002、P=0.025、P=0.007、P=0.001)。结论:TCFA的发生率与患者血尿酸水平升高独立相关,斑块不稳定与血尿酸水平有关。
Objective:The study was designed to determine the relationship between the level of serum uric acid and thin-cap fibroatheroma(TCFA) detected by optical coherence tomography(OCT).Method:A total of 129 patients were recruited from the First Affiliated Hospital of Xinjiang Medical University from January 2015 to February 2018. CHD patient was diagnosed by coronary angiography. The parameters of coronary atherosclerotic plaque were determined based on OCT.The relationship between serum uric acid level and TCFA was analyzed by multiple logistic regression analysis.Result: A total of 129 patients were divided into non-TCFA group(96 cases) and TCFA group(33 cases) based on OCT.①Univariate analyses indicated that patients with TCFA had higher body mass index,smoking,low density lipoprotein,eGFR,uric acid and diabetes compared to those with non-TCFA.In addition, after adjusting for significant confounding factors including smoking,diabetes mellitus,low density lipoprotein, serum uric acid by multivariate regression analysis, multiple logistic regression analysis showed that smoking,diabetes mellitus,low density lipoprotein, and serum uric acid were affect factors of TCFA(P=0.016,P=0.007,P=0.005,P=0.025)and predictor of plaque instability.Serum uric acid was an independent risk factor for the TCFA(OR=1.007,95%CI:1.001-1.014,P=0.025).② Those patients were divided into high group(>420 μmol/L)and low group(<420 μmol/L) according to serum uric acid levels. Difference between the two groups has statistical significance on the thickness of the fibrous cap, lipid arc, invasion degree of macrophages, plaque rupture, thrombosis(P<0.001,P=0.002,P=0.025,P=0.007, P=0.001, respectively). Conclusion:Serum uric acid was an independent influence factor for TCFA.The instability of coronary atherosclerotic plaque was associated with elevated serum uric acid levels.
作者
王钧
李幸
贾璐
李晓梅
刘芬
单春方
金思妤
杨毅宁
WANG Jun;LI Xing;JIA Lu;LI Xiaomei;LIU Fen;SHAN Chunfang;JIN Siyu;YANG Yining(Department of Coronary Heart Disease,Heart Center,the First Affiliated Hospital of Xinjiang Medical University,Urumchi,830011,China)
出处
《临床心血管病杂志》
CAS
北大核心
2019年第3期244-250,共7页
Journal of Clinical Cardiology
基金
新疆自治区科技支疆项目(No:2016E02072)
重大慢性非传染性疾病防控研究(No:2018YFC1312804)
