2型糖尿病患者血尿酸水平與冠脈病變的關聯研究

摘要：目的 探討血尿酸水平與2型糖尿病患者冠狀動脈病變之間的關聯。方法 采用病例對照研究，實驗組158例，選擇2008年1月～2013年8月在我院心血管內科及內分泌科住院的糖尿病合并有冠心病，并經冠脈造影證實的患者；對照組183例：為同期入院排除冠心病的糖尿病患者。對所有納入對象測定禁食8 h后靜脈血清尿酸及其他生物化學指標，并結合造影情況，探討血尿酸水平在2型糖尿病患者中與冠心病發生的作用。結果 實驗組血尿酸水平（381.42±74.12）umol/L顯著高于對照組的（342.56±70.76）umol/L，兩組比較差異有統計學意義（P﹤0.01）。實驗組不同冠脈病變支數亞組之間血尿酸水平比較差異也具有顯著差異（F=7.989，P<0.05），兩兩比較差異也具有統計學意義（P﹤0.05）。多因素Logistic回歸分析顯示，血尿酸升高是糖尿病患者中冠心病發生的獨立危險因素（OR=1.287，95% CI： 1.089-1.456；P=0.003）。結論 本研究人群糖尿病合并冠心病患者血尿酸水平較對照組顯著升高，且與冠心病發生及冠脈狹窄程度具有相關性，血尿酸水平升高可能是在2型糖尿病患者中發生冠心病的一個獨立危險因素。

關鍵詞：血尿酸；冠心病；糖尿病；危險因素

Abstract：Objective To investigate the relationship between serum uric acid level and the presence and severity of type 2 diabetes Amalgamate coronary artery disease. To explore the effect of hyperuricemia to diabetes 2 amalgamate coronary artery disease. Methods The study was designed as a case-control study. A total of 341 subjects were recruited from the Central Hospital of Bazhong. The study group consisted of 158 patients with type 2 diabetes Amalgamate CAD evidenced by coronary arteriography. The control group consisted of 183 subjects without anomaly in coronary arteriography and no history of heart disease. The association between the serum uric acid level and severity of coronary atherosclerosis was analyzed. Results In total， the study group was higher as compared to the control group （381.42±74.12umol/L vs. 342.56±70.76umol/L， P﹤0.05）. Moreover， serum uric acid was significantly associated with the severity of CAD （F=7.989，P<0.05）. In addition， after adjusting for significant confounding factors by multivariate regression analysis， serum uric acid also was an independent risk factor for CAD （OR=1.287，95% CI： 1.089-1.456；P=0.003）. Conclusion There findings suggest that serum uric acid was an independent risk factor for CAD and may be useful as a predictor of the severity of coronary atherosclerosis.

Key words：Serum uric acid；Coronary artery disease；Diabetes mellitus；Association

糖尿病是一種嚴重危害人民群眾身體健康的常見病與多發病，隨著生活水平的提高、生活方式的改變及我國人口老齡化的進程，我國2型糖尿病（type 2 diabetes mellitus，T2DM）逐年升高[1]。研究顯示T2DM患者總死亡率的3/4直接和冠狀動脈粥樣硬化性心臟病（冠心病）相關[2]，但是T2DM大血管并發癥的高發不能完全用高血糖解釋，目前對于血尿酸與T2DM及其大血管并發癥的關系尚有爭議。……