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目的探讨血清尿酸(UA)与ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉(冠脉)介入(PCI)术后冠脉血流的相关性。方法 138例成功实施PCI术的STEMI患者,根据尿酸水平分成高尿酸组42例和尿酸正常组96例,评价PCI术后冠脉血流的相关因素。结果高尿酸组高血压比率(53.8%)、住院时间(9.3±2.0)d、Gensini评分(46.5±16.3)分、B型尿钠肽(BNP)(256.4±61.2)pg/ml、左室射血分数(LVEF)(44.2±8.1)%、超敏C反应蛋白(hs-CRP)(8.8±2.7)mg/L均显著高于尿酸正常组(P<0.05);高尿酸组院内死亡、心肌梗死、严重心律失常及无复流现象的发生率均显著高于尿酸正常组,差异有统计学意义(P<0.05);尿酸[OR=1.02,95%CI(0.98,1.23);P<0.05]是PCI术后患者无复流现象发生的独立危险因素。结论尿酸水平可作为STEMI患者PCI术后冠脉血流受损的一个可靠标记物。
Objective To investigate the correlation between serum uric acid (UA) and coronary blood flow after percutaneous coronary intervention (PCI) in patients with STEMI. Methods A total of 138 patients with STEMI who underwent PCI were divided into two groups based on uric acid level: 42 cases of hyperuricemia group and 96 cases of normal uric acid group. The related factors of coronary blood flow after PCI were evaluated. Results Hypertension group had a high rate of hypertension (53.8%), hospital stay (9.3 ± 2.0) d, Gensini score 46.5 ± 16.3, BNP (256.4 ± 61.2) pg / LVEF 44.2 ± 8.1% and hs-CRP 8.8 ± 2.7 mg / L were significantly higher than those in normal uric acid group (P <0.05) The incidence of infarction, severe arrhythmia and no-reflow phenomenon were significantly higher than that of normal uric acid group (P <0.05). Uric acid (OR = 1.02, 95% CI 0.98,1.23) ] Is an independent risk factor for no-reflow after PCI. Conclusions Uric acid levels may be a reliable marker of impaired coronary blood flow after PCI in STEMI patients.