2型糖尿病患者血尿酸水平与冠脉病变的关联研究(1)
摘要：目的 探讨血尿酸水平与2型糖尿病患者冠状动脉病变之间的关联。方法 采用病例对照研究，实验组158例，选择2008年1月～2013年8月在我院心血管内科及内分泌科住院的糖尿病合并有冠心病，并经冠脉造影证实的患者；对照组183例：为同期入院排除冠心病的糖尿病患者。对所有纳入对象测定禁食8 h后静脉血清尿酸及其他生物化学指标，并结合造影情况，探讨血尿酸水平在2型糖尿病患者中与冠心病发生的作用。结果 实验组血尿酸水平(381.42±74.12)umol/L显著高于对照组的(342.56±70.76)umol/L，两组比较差异有统计学意义(P﹤0.01)。实验组不同冠脉病变支数亚组之间血尿酸水平比较差异也具有显著差异(F=7.989，P<0.05)，两两比较差异也具有统计学意义(P﹤0.05)。多因素Logistic回歸分析显示，血尿酸升高是糖尿病患者中冠心病发生的独立危险因素(OR=1.287，95% CI： 1.089-1.456；P=0.003)。结论 本研究人群糖尿病合并冠心病患者血尿酸水平较对照组显著升高，且与冠心病发生及冠脉狭窄程度具有相关性，血尿酸水平升高可能是在2型糖尿病患者中发生冠心病的一个独立危险因素。
, http://www.100md.com
关键词：血尿酸；冠心病；糖尿病；危险因素
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.
, 百拇医药
Key words：Serum uric acid；Coronary artery disease；Diabetes mellitus；Association
糖尿病是一种严重危害人民群众身体健康的常见病与多发病，随着生活水平的提高、生活方式的改变及我国人口老龄化的进程，我国2型糖尿病(type 2 diabetes mellitus，T2DM)逐年升高[1]。研究显示T2DM患者总死亡率的3/4直接和冠状动脉粥样硬化性心脏病(冠心病)相关[2]，但是T2DM大血管并发症的高发不能完全用高血糖解释，目前对于血尿酸与T2DM及其大血管并发症的关系尚有争议。本研究旨在探讨血尿酸水平与T2DM患者冠心病事件的相关性。
1资料与方法
1.1一般资料 选自2008年02月～2012年03月在我院心内科或内分泌科的住院患者。实验组入选标准：为确诊为糖尿病且合并有冠心病的患者。2型糖尿病诊断根据2007年中国2型糖尿病防治指南公布标准[3]：6.1 mmol/L≤空腹血糖<7.0mmol/L为IFG；空腹血糖≥7.0 mmol/L或<7.0 mmol/L，但过去曾诊断为糖尿病且1个月内使用胰岛素或口服降糖药物治疗的为糖尿病。冠心病诊断参照美国心脏病协会的诊断标准[4]：至少1支或以上主要冠状动脉直径狭窄≥50%，并结合病史、临床症状、心电图改变及实验室检查发现，共158例，男109例、女 49例，年龄(58.81±9.89)岁。, http://www.100md.com(袁旭明 王磊 何昕)
, http://www.100md.com
关键词：血尿酸；冠心病；糖尿病；危险因素
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.
, 百拇医药
Key words：Serum uric acid；Coronary artery disease；Diabetes mellitus；Association
糖尿病是一种严重危害人民群众身体健康的常见病与多发病，随着生活水平的提高、生活方式的改变及我国人口老龄化的进程，我国2型糖尿病(type 2 diabetes mellitus，T2DM)逐年升高[1]。研究显示T2DM患者总死亡率的3/4直接和冠状动脉粥样硬化性心脏病(冠心病)相关[2]，但是T2DM大血管并发症的高发不能完全用高血糖解释，目前对于血尿酸与T2DM及其大血管并发症的关系尚有争议。本研究旨在探讨血尿酸水平与T2DM患者冠心病事件的相关性。
1资料与方法
1.1一般资料 选自2008年02月～2012年03月在我院心内科或内分泌科的住院患者。实验组入选标准：为确诊为糖尿病且合并有冠心病的患者。2型糖尿病诊断根据2007年中国2型糖尿病防治指南公布标准[3]：6.1 mmol/L≤空腹血糖<7.0mmol/L为IFG；空腹血糖≥7.0 mmol/L或<7.0 mmol/L，但过去曾诊断为糖尿病且1个月内使用胰岛素或口服降糖药物治疗的为糖尿病。冠心病诊断参照美国心脏病协会的诊断标准[4]：至少1支或以上主要冠状动脉直径狭窄≥50%，并结合病史、临床症状、心电图改变及实验室检查发现，共158例，男109例、女 49例，年龄(58.81±9.89)岁。, http://www.100md.com(袁旭明 王磊 何昕)