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解放军总医院医学创新研究部、国家老年疾病临床医学研究中心(解放军总医院)、解放军总医院第六医学中心心血管病医学部
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中华老年多器官疾病杂志编辑委员会
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创刊人 王士雯
总编辑 范利
副总编辑 陈韵岱
执行主编 叶大训
编辑部主任 王雪萍
ISSN 1671-5403
CN 11-4786
创刊时间 2002年
出版周期 月刊
邮发代号 82-408
友情链接
李冬云,林莹,董文静,狐亚磊,李可.血清尿酸对急性冠脉综合征患者治疗后6个月内再入院的预测价值[J].中华老年多器官疾病杂志,2022,21(9):675~678
血清尿酸对急性冠脉综合征患者治疗后6个月内再入院的预测价值
Predictive value of serum uric acid on readmission of acute coronary syndrome patients within 6 months after treatment
投稿时间:2022-06-19  
DOI:10.11915/j.issn.1671-5403.2022.09.146
中文关键词:  血清尿酸  急性冠脉综合征  再入院  危险因素
英文关键词:serum uric acid  acute coronary syndrome  readmission  risk factors This work was supported by the Project for Clinical Medical Research Center of Hainan Science and Technology Plan
基金项目:海南省科技计划(临床医学研究中心)项目(LCYX202106)
作者单位E-mail
李冬云 中国人民解放军总医院第二医学中心保健一科,北京 100853: likesxcn@163.compredictive 
林莹 中国人民解放军总医院海南医院 心血管内科,海南 三亚 572013 likesxcn@163.compredictive 
董文静 中国人民解放军总医院海南医院 老年医学科,海南 三亚 572013 likesxcn@163.compredictive 
狐亚磊 中国人民解放军总医院海南医院 血液病科,海南 三亚 572013 likesxcn@163.compredictive 
李可 中国人民解放军总医院海南医院 心血管内科,海南 三亚 572013 likesxcn@163.compredictive 
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中文摘要:
      目的 探讨血清尿酸(SUA)对急性冠脉综合征(ACS)患者治疗后6个月内再入院的预测价值。方法 选取2016年1月至2019年3月于中国人民解放军总医院海南医院心血管内科住院治疗的ACS患者为研究对象。采用单因素分析及二元logistic回归分析探究SUA对ACS患者治疗后6个月内再入院的相关危险因素。通过受试者工作特征(ROC)曲线分析SUA对于再入院的预测价值。采用SAS9.4和R4.0.3软件进行数据分析。根据数据类型,组间比较分别采用t检验、Mann-Whitney U检验、χ2检验及Bonferroni检验。结果 共纳入462例患者,再入院组47例,非再入院组415例。单因素分析结果显示,2组治疗方式比较,差异有统计学意义(P<0.05);再入院组高血压、SUA、关节结石及住院期间不良事件发生情况均高于非再入院组,差异均有统计学意义[34例(72.34%) 和 231例(55.66%),(394.77±106.29)和(346.17±91.58)μmol/L,13例(27.66%) 和18例(4.34%),12例(14.46%)和16例(3.86%); 均 P<0.05];再入院组肾小球滤过率和他汀类药物使用人数低于非再入院组,差异均有统计学意义[81.04(72.01,106.02) 和 92.98(78.76,106.62) ml/(min·1.73m2), 36例(76.60%) 和 372例(89.64%);均 P<0.05]。多因素分析结果显示,SUA(OR = 1.004,95%CI 1.001~1.006)、治疗方式(OR=5.027,95%CI 2.855~8.853)、住院期间不良事件(OR = 0.144,95%CI 0.050~0.410)与出院后6个月再住院相关(P<0.05)。且随血清尿酸水平的升高,ACS患者再入院比例升高。SUA对出院后6个月内再入院事件的曲线下面积为0.649。结论 SUA水平升高会增加ACS患者治疗后6个月内再入院的风险,并对再入院的风险具有一定的预测价值。
英文摘要:
      Objective To investigate the association of serum uric acid (SUA) with readmission within 6 months after treatment in patients with acute coronary syndrome (ACS), and to investigate the predictive value of SUA for readmission within 6 months. Methods A retrospective cohort trial was carried out on the ACS patients hospitalized in Department of Cardiology of Chinese PLA General Hospital Hainan Hospital from January 2016 to March 2019. Univariate and binary logistic regression analyses were used to explore the related risk factors of readmission within 6 months after treatment. Receiver operating characteristic (ROC) curve was drawn to analyze the predictive performance of SUA for readmission. SAS9.4 and R4.0.3 were used for statistical analysis. Data comparison between two groups was perfomed using t test, Mann-Whitney U test, χ2 test or Bonferroni test depending on data type. Results A total of 462 patients were included in this study, and 47 of them were finally assigned into the readmission group and 415 into the non-readmission group in 6 months after treatment. Univariate analysis showed statistical significance in treatment method between the 2 groups (P<0.05). The patients from the readmission group had obviously higher SUA level (394.77±106.29 vs 346.17±91.58 μmol/L), larger ratios of hypertension [34 (72.34%) vs 231 cases (55.66%)], arthrolithiasis [13 (27.66%) vs 18 cases (4.34%)], and higher incidence of adverse events during hospitalization [12 (14.46%) vs 16 cases (3.86%)], but lower estimated glomerular filtration rate [1.04 (72.01,106.02) vs 92.98 (78.76,106.62) ml/(min·1.73 m2)] and proportion of statin use [36 (76.60%) vs 372 cases (89.64%)] when compared with those of the non-readmission group (all P<0.05). Multivariate analysis indicated that SUA level (OR =1.004,95%CI 1.001-1.006), treatment method (OR=5.027,95%CI 2.855-8.853) and adverse events during hospitalization (OR=0.144, 95%CI 0.050-0.410) were closely associated with readmission within 6 months after discharge (all P<0.05). The higher the SUA level was, the higher proportion of readmission in the ACS patients, and the area under the ROC curve of SUA for readmission was 0.649. Conclusion Elevated SUA level increases the risk of readmission within 6 months after discharge in ACS patients and has predictive value for the risk.
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