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1960年Dreyfuss指出,一世纪前曾记载痛风与动脉硬化有关,并认为高尿酸血症确是冠心病(coronary heart disease,CHD)的危险因素。嗣后,虽有许多关于高尿酸血症在CHD中作用的报告,但仍有争议。本文探讨血清尿酸(serum uric acid,SUA)升高作为CHD危险因素的证据。 SUA与CHD 1951年Gertler等报道SUA上升与40岁以下男性心肌梗塞有关。1963年Dawber对一组病例随访8年也证实SUA增高与CHD有相关性,且发现当血压和血胆固醇的影响消除后,SUA与CHD相关性明显减少,因而认为尿酸本身并非主要的危险因素。1967年Kannel等随访一组病人12年,亦发现CHD危险性随SUA增高而增加。
1960 Dreyfuss pointed out that a century ago, gout was documented and atherosclerosis, and that hyperuricemia is indeed a risk factor for coronary heart disease (CHD). Subsequently, although there are many reports on the role of hyperuricemia in CHD, there is still controversy. This article investigates elevated serum uric acid (SUA) as a risk factor for CHD. SUA and CHD In 1951, Gertler et al reported that the rise of SUA was related to myocardial infarction in men under the age of 40. In 1963, Dawber’s follow-up of 8 years in a group of patients also confirmed the correlation between elevated SUA and CHD. He found that the correlation between SUA and CHD was significantly reduced after the influence of blood pressure and blood cholesterol was eliminated. Therefore, uric acid was not the main risk factor. In 1967, Kannel et al followed a group of patients for 12 years and found that the risk of CHD increased with the increase of SUA.