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目的急性冠脉综合征是临床常见的急性心血管疾病,是导致患者死亡的重要原因。本研究旨在探讨急性冠脉综合征患者血尿酸(UA)水平变化及与同型半胱氨酸(Hcy)、T细胞亚群、血脂的关系,为临床治疗提供依据。方法选取2015年4月—2016年10月于温州市中医院就诊的急性冠脉综合征患者84例,其中不稳定型心绞痛(UAP)患者40例作为UAP组,急性心肌梗死(AMI)患者44例作为AMI组,另选同期健康体检者40例作为对照组。观察3组UA、Hcy、T细胞亚群、血脂变化,并探究急性冠脉综合征患者UA水平变化与Hcy、T细胞亚群、血脂的关系。结果 UAP组、AMI组患者UA、Hcy水平均明显高于对照组(P<0.05),且AMI组患者UA、Hcy水平升高更显著(P<0.05);UAP组、AMI组患者T细胞亚群CD4+CD25+Treg、CD4+CD25highTreg均明显低于对照组(P<0.05),且AMI组患者UA、Hcy水平降低更显著(P<0.05);UAP组、AMI组患者血脂指标总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)均明显高于对照组(P<0.05),高密度脂蛋白(HDL)均明显低于对照组(P<0.05),但UAP组、AMI组间无明显差异(P>0.05);相关性分析结果显示,急性冠脉综合征患者UA与Hcy、TC、TG、LDL呈正相关(P<0.05),与HDL呈负相关(P<0.05)。结论急性冠脉综合征患者存在UA、Hcy水平异常升高、免疫功能下降、血脂代谢紊乱,且UA水平升高与Hcy、血脂水平有关。
Objective Acute coronary syndrome is a common clinical cardiovascular disease and is an important cause of death in patients. The purpose of this study was to investigate the changes of serum uric acid (UA) and its relationship with homocysteine (Hcy), T lymphocyte subsets and blood lipids in patients with acute coronary syndrome and to provide evidence for clinical treatment. Methods Eighty-four patients with acute coronary syndrome who were admitted to Wenzhou TCM Hospital from April 2015 to October 2016 were enrolled. Forty patients with unstable angina pectoris (UAP) were enrolled as UAP group and 44 with acute myocardial infarction (AMI) Cases as an AMI group, another 40 cases of the same period health examination as a control group. The changes of UA, Hcy, T lymphocyte subsets and blood lipids in the three groups were observed. The relationship between UA levels and Hcy, T lymphocyte subsets, blood lipids in patients with acute coronary syndrome was also explored. Results The levels of UA and Hcy in UAP group and AMI group were significantly higher than those in control group (P <0.05), and the levels of UA and Hcy in AMI group were significantly higher than those in AMI group (P <0.05) The levels of CD4 + CD25 + Treg and CD4 + CD25highTreg in the UAP group and the AMI group were significantly lower than those in the control group (P <0.05), and the levels of UA and Hcy in the AMI group were significantly lower (P <0.05) TC, TG and LDL were significantly higher than those in the control group (P <0.05), and HDL were significantly lower than those in the control group (P <0.05), but UAP There was no significant difference between the AMI group and the AMI group (P> 0.05). Correlation analysis showed that there was a positive correlation between UA and Hcy, TC, TG and LDL in acute coronary syndrome (P <0.05) <0.05). Conclusions UA and Hcy levels are abnormally elevated in patients with acute coronary syndrome, with decreased immune function and dyslipidemia. UA levels are associated with Hcy and blood lipid levels.