代谢综合征联合高尿酸血症评估冠心病发病风险的价值

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摘要目的: 探讨代谢综合征联合高尿酸血症评估冠心病发病风险的价值。方法: 选取因胸部闷痛就诊患者412例，其中代谢综合征患者188例及非代谢综合征患者224例，以血清尿酸水平420 μmol/L（男性）或360 μmol/L（女性）为切点分为非代谢综合征未合并高尿酸血症组（A组）、非代谢综合征合并高尿酸血症组（B组）、代谢综合征未合并高尿酸血症组（C组）、代谢综合征合并高尿酸血症组（D组）。比较4组间各项临床指标及冠心病患病比例的差异。采用Logistic回归分析代谢综合征、尿酸及相关因素与冠心病的关系。结果：与非代谢综合征组相比，代谢综合征组体重、体重指数（BMI）、舒张压、尿素氮、尿酸、三酰甘油、空腹血糖均明显升高（P<0.05），高密度脂蛋白胆固醇明显降低（P<0.05）。各亚组间体重、BMI、尿素氮、尿酸、空腹血糖、三酰甘油、低密度脂蛋白胆固醇差异具有统计学意义（P<0.05），冠心病患病比例在A组、B组、C组、D组依次升高，D组冠心病患病率明显高于A组、B组、C组（P<0.05）。Logistic回归分析显示，代谢综合征、年龄、中高水平尿酸、AST及男性是冠心病的危险因素。随着尿酸浓度的增加，冠心病患病风险性显著升高。结论：与单用代谢综合征或单用高尿酸血症相比，两者联合预测冠心病发病风险价值更高。

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关键词 ：代谢综合征, 高尿酸血症, 冠心病

Abstract：Objective: To investigate the predictive and diagnostic value of the metabolic syndrome (MS) combined with hyperuricemia (HUA) for coronary heart disease. Methods: A total of 412 cases of patients were divided into metabolic syndrome patients (MS,n=188) and nonmetabolic syndrome patients(NonMS,n=224). The data were divided into 4 groups according to the level of UA; NonMS with NonHUA(group A), NonMS with HUA(group B), MS with NonHUA(group C), MS with HUA(group D). The clinical indexes of each group were detected and the risk of coronary heart disease was analyzed. Logistic regression analysis was performed to evaluate risk factors of coronary heart disease. Results: In a comparison with the NonMS group, the body weight, BMI,DBP, BUN, UA,TG and FPG were significantly elevated (P<0.05) and HDLC was reduced(P<0.05) in patients with MS.The morbidity rate of coronary heart disease, in group A, group B, group C, group D, was gradually and remarkably increased. The morbidity rate of coronary heart disease of group D when compared with group A, group B,group C,there are statistically significant(P<0.05). In addition, Logistic regression analysis confirmed that age, male, metabolic syndrome,HUA,AST are risk factors for coronary heart disease.The risk of coronary heart disease dramatically increased along with higher uric acid level. Conclusion: MS combined with HUA might be more advantageous in evaluating coronary heart disease than that of MS or HUA alone.

收稿日期: 2018-05-10

基金资助:国家自然科学基金资助项目（81870548，81570721，81370965）；江苏省自然科学基金资助项目（BE2018692，BK20151331）；江苏省高层次卫生人才“六个一工程”项目（LGY2016053）；江苏省“六大人才高峰”项目（2015-WSN-006）

通讯作者: 袁国跃（通讯作者），主任医师，教授，博士生导师，Email ：yuanguoyue@hotmail.com

作者简介: 赵越（1988—），女，硕士研究生；

引用本文:

赵越1，钱唯韵2，王东1，杨玲1，赵丽1，李彦彦1，洪霞飞1，邓家良1，王璇3，袁国跃. 代谢综合征联合高尿酸血症评估冠心病发病风险的价值[J]. 江苏大学学报:医学版, 2018, 28(05): 418-422. ZHAO Yue1, QIAN Wei-yun2, WANG Dong1, YANG Ling1, ZHAO Li1, LI Yan-yan1,HONG Xia-fei1, DENG Jia-liang1, WANG Xuan3, YUAN Guo-yue1. The value of metabolic syndrome with hyperuricemia in assessing the risk of coronary heart disease. Journal of Jiangsu University(Medicine Edition), 2018, 28(05): 418-422.

链接本文:

http://zzs.ujs.edu.cn/xbyxb/CN/ 或 http://zzs.ujs.edu.cn/xbyxb/CN/Y2018/V28/I05/418

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