目的 探讨新发心肌梗死与血清尿酸水平之间的关系.方法 选取2009年2月~2014年12月于四川省广元市第二人民医院治疗的急性心肌梗死患者280例(AMI组),其中男性166例,女性114例,年龄23~75岁,平均年龄(56.39±12.93)岁.同时选取在心内科住院的非急性心肌梗死患者100例作为对照组,其中男性59例,女性41例,年龄26~69岁,平均年龄(55.10±14.41)岁.所有心肌梗死患者于6 h内行冠状动脉造影,明确相关梗死血管,结合心电图表现,分为单病灶组(178例)和多病灶组(102例).所有入选者检测血清尿酸、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC)及三酰甘油(TG).同时测定胸痛发作后12 h的肌酸激酶同工酶(CK-MB).测量左室舒张末期内径(LVEDD),Simpson法测量左室射血分数(LVEF).结果 AMI组血清尿酸为(352.18±65.20)mmol/L,明显高于对照组(301.37±72.08)mmol/L,差异有统计学意义(P<0.01).与单病灶组比较,多病灶组血清尿酸[(322.17±69.40)mmol/Lvs.(374.38±54.39)mmol/L]、CK-MB[(40.32±18.41)U/Lvs.(75.50±20.27)U/L]、LVEDD[(47.53±6.39)mmvs.(54.30±5.13)mm]升高,LVEF[(61.27±7.18)%vs.(41.94±8.54)%]降低,差异有统计学意义(P均<0.01).两组血脂水平比较,差异无统计学意义(P均>0.05).相关性分析显示,急性心肌梗死患者血清尿酸与CK-MB呈正相关(r=0.589,P<0.05),与LVEF呈负相关(r=-0.605,P<0.05),与LVEDD无相关性(P>0.05).结论 新发心肌梗死患者血清尿酸水平升高,同时血清尿酸水平越高心功能越差,心肌损伤越严重.
Objective To investigate the relationship between acute myocardial infarction (AMI) and level of serum uric acid (UA).Methods AMI patients (n=280, male 166, female 114, aged from 23 to 75 and average age=56.39±12.93) were chosen from Feb. 2009 to Dec. 2014 as AMI group, and non-AMI patients (n=100, male 59, female 41, aged from 26 to 69 and averaged age=55.10±14.41) were chosen as control group at the same time. All AMI patients were given coronary angiography (CAG) within 6 h for determining infarction vessels, and then divided into single-focus group (n=178) and multi-focus group (n=102) based on outcomes of electrocardiogram (ECG). The levels of serum UA, low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), total cholesterol (TC) and triglyceride (TG) were detected, and meanwhile creatine kinase MB (CK-MB) was detected after chest pain attack for 12 h. The changes of left ventricular end-diastolic inner diameter (LVEDd) were detected, and left ventricular ejection fraction (LVEF) was detected by using Simpson's method.Results The level of serum UA was (352.18±65.20) mmol/L and (301.37±72.08) mmol/L in control group (P<0.01). The levels of serum UA [(322.17±69.40) mmol/Lvs. (374.38±54.39) mmol/L], CK-MB [(40.32±18.41) U/Lvs. (75.50 ±20.27) U/L], LVEDd [(47.53±6.39) mmvs. (54.30±5.13) mm] increased, and LVEF [(61.27±7.18)%vs. (41.94 ±8.54)%] decreased in multi-focus group compared with multi-focus group (all P<0.01). The difference in level of blood fat had no statistical significance (all P>0.05). The correlation analysis showed that serum UA was positively correlated to CK-MB (r=0.589,P<0.05), negatively correlated to LVEF (r=-0.605,P<0.05) and not correlated to LVEDd (P>0.05).Conclusion The level of serum UA increases in patient with AMI, and myocardial injury will be more serious as increase of serum UA level and decrease of heart function.