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目的探讨老年女性高尿酸血症(Hyperuricemia,HUA)与冠状动脉造影确诊的冠心病的冠脉病变程度的关系。方法回顾性分析400例老年女性,根据冠状动脉造影结果分为两组,冠心病组260例,非冠心病组即对照组140例,观察两组吸烟、高血压病、2型糖尿病、高脂血症、冠心病家族史、体重指数及高尿酸血症与冠心病发病的关系。再将老年女性按血尿酸浓度>360μmol/L的标准诊断高尿酸血症分为HUA组与非HUA组,观察HUA与冠脉病变支数及Gensini积分的关系。结果①老年女性冠心病组高尿酸血症的比例(23.1%)高于对照组(12.1%),差异有统计学意义(P<0.05)。②HUA为老年女性冠心病发生的影响因素(OR=2.171,95%CI:1.223～3.853,Waldχ2=6.99),但对其他指标进行校正采用多因素Logisitic逐步回归进行危险因素筛选,HUA并不是老年女性冠心病发生的独立危险因素。③老年女性病变血管支数的分布在HUA组与非HUA组之间差异有统计学意义(Z=2.78,P<0.05)。老年女性HUA患者的Gensini积分高于非HUA患者(Z=2.08P<0.05),且在女性的全组、HUA组及非HUA组Gensini积分与血尿酸水平均呈正相关(rs=0.177,0.213,0.152,P<0.05)。结论老年女性HUA与冠心病发生有一定关联,但不是独立危险因素,HUA是反应冠心病病情程度的一个重要指标。老年女性高尿酸血症患者在冠心病诊治上应引起重视。
Objective To investigate the relationship between hyperuricemia (HUA) in elderly women and coronary artery disease with coronary angiography. Methods A retrospective analysis of 400 elderly women, divided into two groups according to coronary angiography results, coronary heart disease group 260 cases, non-coronary heart disease control group 140 cases, two groups of smoking, hypertension, type 2 diabetes, Serum levels of coronary heart disease, familial history of coronary heart disease, body mass index and hyperuricemia. The elderly women were divided into HUA group and non-HUA group according to the standard diagnosis of hyperuricemia with uric acid concentration> 360μmol / L. The relationship between HUA and coronary artery lesion count and Gensini score was observed. Results ① The percentage of hyperuricemia in elderly women with coronary heart disease (23.1%) was significantly higher than that in the control group (12.1%) (P <0.05). (2) HUA was the influencing factor of coronary heart disease in elderly women (OR = 2.171, 95% CI: 1.223-3.853, Waldχ2 = 6.99), but other indicators were corrected by multi-factor Logisitic stepwise regression. Independent risk factors for coronary heart disease. (3) The distribution of blood vessel count in elderly female patients was significantly different between HUA group and non-HUA group (Z = 2.78, P <0.05). The Gensini scores of elderly HUA patients were higher than those of non-HUA patients (Z = 2.08P <0.05). There was a positive correlation between Gensini score and blood uric acid levels in all women, HUA group and non HUA group (rs = 0.177,0.213, 0.152, P <0.05). Conclusion HUA is associated with coronary heart disease in elderly women, but it is not an independent risk factor. HUA is an important indicator of the severity of coronary heart disease. Elderly women with hyperuricemia should pay attention to the diagnosis and treatment of coronary heart disease.