| 吕 琼,赵 狄,董平栓,周慧源,姜沙沙.血尿酸水平对ST段抬高型心肌梗死患者急诊经皮冠状动脉介入术后长期预后的影响[J].,2020,(6):1129-1133 |
| 血尿酸水平对ST段抬高型心肌梗死患者急诊经皮冠状动脉介入术后长期预后的影响 |
| Effect of Serum Uric Acid Level on Long-term Prognosis of ST-elevation Myocardial Infarction Patients after Emergency Percutaneous Coronary Intervention |
| 投稿时间：2019-06-24 修订日期：2019-07-19 |
| DOI：10.13241/j.cnki.pmb.2020.06.029 |
| 中文关键词: ST段抬高型心肌梗死 经皮冠状动脉介入治疗 血尿酸 预后 危险因素 |
| 英文关键词: ST-elevation myocardial infaction Percutaneous coronary intervention Serum uric acid Prognosis Risk factors |
| 基金项目:国家自然科学联合基金项目（U1604162）；洛阳市科技计划医疗卫生项目重点专科项目（1718001A） |
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| 中文摘要: |
| 摘要 目的：探讨血尿酸（SUA）水平对行急诊经皮冠状动脉介入治疗（PCI）的ST段抬高型心肌梗死（STEMI）患者长期预后的影响。方法：连续纳入2012年1月至2012年12月在我院诊断为STEMI并成功行急诊PCI的患者275例，按照入院时SUA水平三分位法将患者分成A组91例（低尿酸）、B组90例（中尿酸）、C组94例（高尿酸）。收集所有患者临床基线资料，包括吸烟史、既往病史、血液学指标及冠脉造影结果等，观察三组患者急诊PCI术后住院期间及术后6年随访期间主要不良心血管事件（MACE）的发生情况，logistic回归分析SUA水平对患者近期及长期预后的危险因素。结果：C组男性和心律失常病史比例明显高于A、B组（P＜0.05）。同时，三组患者AIP、Scr、BUN、SUA、APTT组间比较差异有统计学意义（P＜0.05）。C组患者三支血管病变比例明显高于A、B组，差异有统计学意义（P＜0.05）。三组患者住院期间心力衰竭、支架内血栓形成、总MACE比例组间比较差异有统计学意义（P＜0.05）。三组患者术后6年心力衰竭、心绞痛、支架内再狭窄/闭塞和总MACE比例组间比较差异有统计学意义（P＜0.05）。Logistic回归显示年龄、吸烟史、TC、SUA、血栓抽吸术、IABP应用是住院期间MACE发生的危险因素（P＜0.05），AIP、SUA、APTT、IABP应用是PCI术后6年随访期间MACE发生的危险因素（P＜0.05）。结论：成功行急诊PCI的STEMI患者，SUA水平是其近期及长期预后的独立危险因素，SUA水平升高者长期MACE发生率增加。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effect of serum uric acid (SUA) level on the long-term prognosis of ST-elevation myocardial infarction (SETMI) patients who underwent emergency percutaneous coronary intervention(PCI). Methods: 275 patients who were diagnosed as STEMI and successfully performed emergency PCI in our hospital from January 2012 to December 2012 were enrolled in this study. According to the SUA level three-position method at admission, the patients were divided into group A(91 cases of low uric acid), group B(90 cases of medium uric acid) and group C(94 cases of high uric acid). The clinical baseline data including smoking history, past medical history, hematological indicators and coronary angiographic results were collected and analyzed. The incidence of major adverse cardiovascular events (MACE) during hospitalization and 6-year follow-up after emergency PCI in the three groups was observed. The risk factors of SUA level for short-term and long-term prognosis were analyzed by logistic regression. Results: The proportion of male and arrhythmia history in group C was significantly higher than that in group A and B (P<0.05). Meanwhile, there were significant differences in AIP, Scr, BUN, SUA and APTT among the three groups (P<0.05). The proportion of three vessel lesions in group C were significantly higher than that in group A and B (P<0.05). There were significant differences in heart failure, stent thrombosis and total MACE ratio among the three groups during hospitalization (P<0.05). There were significant differences in heart failure, angina pectoris, in-stent restenosis/occlusion and total MACE ratio among the three groups 6 years after operation (P<0.05). Logistic regression showed that age, smoking history, TC, SUA, thrombus aspiration and IABP application were risk factors for MACE during hospitalization (P<0.05), while AIP, SUA, APTT and IABP application were risk factors for MACE during 6-year follow-up after PCI (P<0.05). Conclusion: SUA level is an independent risk factor for short-term and long-term prognosis in STEMI patients who have successfully performed emergency PCI. The incidence of long-term MACE increases in patients with elevated SUA level. |
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