80岁及以上老人高尿酸血症与急性心肌梗死事件的相关性研究

目的评价血尿酸与80岁及以上老人发生急性心肌梗死的相关性。方法以2001年1月至2001年12月在我院进行常规查体的80岁及以上老人为研究对象,共342例,平均年龄85.6±4.0岁。血尿酸≥420μmol/L为高尿酸血症,记录急性心肌梗死事件,随访79.02±37.92个月(2～119个月)。结果高尿酸血症占33.0%(113/342),Logistic回归分析血尿酸升高与估测肾小球滤过率(eGFR)下降相关[OR(95%CI)为0.975(0.953～0.997),P值=0.03]。随访中有急性心肌梗死39例,高尿酸血症组急性心肌梗死发生率高于尿酸正常组(18.6%比8.0%,χ2=8.17,P值=0.004)。COX回归分析表明,调整混杂因素后,高尿酸血症[RR(95%CI)为2.34(1.13～4.85),P=0.02]是发生急性心肌梗死事件的独立危险因素。结论在80岁及以上老人中,高尿酸血症的比例较高,高尿酸血症与eGFR下降相关,并且与发生急性心肌梗死事件独立相关。

Study of Hyperuricemia with Acute Myocardial Infarction Event in Patiens Aged 80 Years or Older

Objective To determine the relationship between serum uric acid! （SUA） with acute myo- cardial infarction in patients aged 80 years or older. Methods Data for this retrospective prognostic study were drawn from the patient database in our hospital for routine checkup in January 2001 to December 2001, 342 cases aged 80 and over （ average age 85.6 ± 4.0 years older） were recorded. I~gistic regression analysis was used to analyze the influencing factors of hyperuricemia. Follow-up for incident acute myocardial infarction was complete until December 31,2010. follow-up lime is 79.02 ±37.92 months （2 - 119 months）. Data were analyzed with COX proportional hazards models with adjustment for relevant confounders. Results Hyperuricemia accounted for 33.0% （113/342）, Logistic regression analysis revealed a significant association between hyperurieemia and decreased eGFR [ OR （95% CI） 0. 975 （0. 953 - 0. 997）, P = 0. 03 ]. The acute myocardial infarction rate in hyperurieemia group was significantly higher than the normal SUA group （18.6% vs. 8.0% ,χ^2 = 8.17,P = 0. 004）. COX multivariate analysis revealed that after muhivariable ad- justment, hyperuricemia （ RR = 2.33,95% CI 1.13 - 4.85,P = 0.02） is an independent risk factor for acute myocardial infarction. Conclusion Hyperuricemia is common in elderly aged 80 and over, which is independently correlated with eGFR decline. Hyperurieemia was independent risk factor for acute myocardial infaretion in patients aged 80 years older