冠心病患者血尿酸水平与薄纤维帽粥样硬化斑块的关系

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摘要目的研究冠心病患者血尿酸（UA）水平与薄纤维帽粥样硬化斑块（TCF）之间的关系。方法选取2016年3月～2019年3月于河北医科大学附属廊坊市人民医院就诊的冠心病患者110例作为研究对象，基于光学相关断层扫描（OCT）检测结果将其分为：TCF组35例，非TCF组75例。收集患者基线资料及检测生化指标，logistic多因素回归分析UA与TCF的关系。结果 TCF组冠心病家族史比率、体重指数、低密度脂蛋白及UA水平明显高于非TCF组，差异均有统计学意义（均P ＜ 0.05）；两组患者年龄、性别、吸烟史比率、饮酒史比率、高血压比率、糖尿病比率、治疗方式、高密度脂蛋白、三酰甘油、总胆固醇、心肌肌钙蛋白、肌酸激酶同工酶MB、超敏C反应蛋白、B型钠尿肽、肌酐比较，差异无统计学意义（P ＞ 0.05）。OCT检测结果显示TCF组纤维帽厚度明显低于非TCF组，而脂质弧度、斑块破裂及血栓比率明显高于非TCF组，差异均有统计学意义（均P ＜ 0.05），而两组患者血管钙化比率、滋养血管比率、斑块侵蚀比率、最小管腔面积、狭窄率比较，差异无统计学意义（P ＞ 0.05）。相关性分析显示TCF组患者的UA水平与斑块破裂、血栓形成及脂质弧度呈显著正相关（r ＞ 0，P ＜ 0.05），而与纤维帽厚度呈显著负相关（r ＜0，P ＜ 0.05）。logistic多因素回归分析结果显示UA、冠心病家族史及LDL是TCF的独立危险预测因子（均P ＜ 0.05）。结论冠心病患者UA水平与TCF、斑块破裂及血栓形成显著相关，且UA水平是TCF发生的独立危险预测因子。

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	李雅超杨彦立安蕾张春燕薛增明

关键词 ：冠心病, 尿酸, 薄纤维帽粥样硬化斑块, 光学相关断层扫描

Abstract：Objective To investigate the relationship between serum uric acid (UA) levels and atherosclerotic plaque in thin-cap fibroatheroma (TCF) in patients with coronary heart disease. Methods A total of 110 patients with coronary heart disease admitted to Langfang People′s Hospital Affiliated to Hebei Medical University from March 2016 to March 2019 were selected as the research object. Based on the results of optical correlation tomography (OCT), they were divided into TCF group (35 cases) and non-TCF group (75 cases). Baseline data of patients were collected and biochemical indicators were detected. The relationship between UA and TCF was analyzed by logistic multivariate regression. Results The rate of the family history of coronary heart disease, body mass index, low density lipoprotein and UA levels in the TCF group were significantly higher than those in the non-TCF group, with statistically significant differences (all P ＜ 0.05). There was no significant difference between the two groups in age, sex, ratio of smoking history, ratio of drinking history, ratio of hypertension, ratio of diabetes, treatment, high density lipoprotein, triacylglycerol, total cholesterol, cardiac troponin, creatine kinase isoenzyme MB, hypersensitive C-reactive protein, B-type natriuretic peptide and creatinine (P ＞ 0.05). OCT test results showed that the thickness of fiber cap in the TCF group was significantly lower than that in the non-TCF group, while the ratio of lipid radians, plaque rupture and thrombus was significantly higher than that in the non-TCF group, with statistically significant differences (all P ＜ 0.05). However, there were no statistically significant differences between the two groups in the ratio of vascular calcification, the ratio of nourishing blood vessels, the ratio of plaque erosion, the minimum lumen area and the stenosis rate (P > 0.05). Correlation analysis showed that UA level in TCF group was significantly positively correlated with plaque rupture, thrombosis and ratio of lipid radians (r ＞ 0，P ＜ 0.05), while significantly negatively correlated with fiber cap thickness (r ＜0，P ＜ 0.05). Logistic multivariate regression analysis showed that UA, family history of coronary heart disease and LDL were independent risk predictors of TCF (all P ＜ 0.05). Conclusion UA level in patients with coronary heart disease was significantly correlated with TCF, plaque rupture and thrombosis, and UA level was an independent risk predictor of TCF.

Key words： Coronary heart disease Uric acid Atherosclerotic plaque in thin-cap fibroatheroma Optical coherence tomography

基金资助:河北省重点研发计划自筹项目（182777166）；
河北省廊坊市科技支撑计划项目（2016013014）。

通讯作者: 薛增明（1976.9-），男，博士，副主任医师；研究方向：冠心病介入治疗和急危重症心脏病的抢救。

引用本文:

李雅超杨彦立安蕾张春燕薛增明. 冠心病患者血尿酸水平与薄纤维帽粥样硬化斑块的关系[J]. 中国医药导报, 2020, 17(14): 61-64,68.
LI Yachao YANG Yanli AN Lei ZHANG Chunyan XUE Zengming. Relationship between serum uric acid level and atherosclerotic plaque in thin-cap fibroatheroma in patients with coronary heart disease. 中国医药导报, 2020, 17(14): 61-64,68.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2020/V17/I14/61

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