| objectiveAt present,the global acute coronary syndrome(ACS)prevention and control situa tion is severe.Statistics show that the number of patients in ACS is 1,400 thousa nd in the United States,and in our country is up to 2,500 thousand.The incidenc e of cardiovascular events is 15-20% within 1 year,and the death rate of 6 mont hs is up to 5-8%.Acute myocardial infarction(AMI),as a type of ASC,has high er disability and mortality.Therefore,it is of great clinical significance to identify and diagnose AMI early and reduce its risk.The common pathological characteristi cs of AMI patients are the rupture and thrombosis of coronary atherosclerotic plaq ues,including plaque erosion and vasospasm.In view of this pathogenesis,we are trying to explore more testing indicators and technical means,so that we can ident ify and intervene early in AMI.In recent years,we have found that uric acid(U A)is associated with metabolic syndrome and a variety of renal diseases.UA ma y affect the formation of atherosclerotic plaques through lipid metabolic disorders,and previous studies have found that carotid intima membrane thickness(CIMT)is associated with carotid atherosclerosis.The purpose of this study is to explore w hether the elevated level of UA can accelerate the progression of AMI by means of promoting lipid metabolism disorder and inflammatory response through the ana lysis of clinical case data.To investigate the clinical significance of uric acid and carotid intima media thickness to the degree of coronary angiopathy in AMI patie nts,and to explore a better predictor of AMI as a risk identification factor for A MI in the population.MethodLooking back the 102 cases of AMI patients with successful coronary angiograph y.The average age was(58 + 11.75)years.They were divided into 24 cases of high uric acid group and 78 cases in the control group(normal uric acid group)a ccording to hyperuricemia.The general health status of the patients was collected,including current medical history,past medical history,smoking status,drinking co nditions,and biochemical tests at admission: serum uric acid(UA),hypersensitive C-reactive protein(Hs-CRP),total bilirubin(TB),Serum creatinine(SCr),total choles terol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low de nsity lipoprotein cholesterol(LDL-C),fasting blood-glucose(FBG);plasma endoth elin(ET);carotid intima-media thickness(CIMT);the examination results of coron ary angiography.The selected subjects all signed the relevant informed consent,w hich conformed to the requirements of the basic norms of medical ethics.Result(1)From the analysis of the high uric acid group and the control group,the level s of triglyceride(TG),hypersensitive C reactive protein(Hs-CRP)and plasma end othelin(ET)in the high uric acid group were significantly increased,and the diffe rence was statistically significant(P=0.028,0.001,0.001).(2)From the data analysis of hyperuricemia group and control group,it can be se en that there is a significant difference between the two groups of CIMT(P=0.001).(3)By comparing and analyzing the data of CAG examination,we can get the fol lowing conclusion: UA is positively correlated with Gensini score(r=0.249,P=0.012).(4)According to the international general Gensini score,the AMI patients were di vided into two groups and the results showed that CIMT was positively correlated with the Gensini score(r=0.703,P=0.000).ConclusionThis study is based on the AMI population in our country.This study analyzed a nd evaluated the clinical diagnosis and treatment value of UA and CIMT for the f irst time.The significance of this study is to explore the pathogenesis of carotid a nd coronary atherosclerosis by inducing the mechanism of lipid metabolism disorde r and inflammatory response.UA and CIMT should be a priority index to evaluat e the progress of coronary artery disease in clinic,so as to optimize and simplify the diagnosis of AMI.The ultimate aim is to make early intervention for high-risk patients with AMI to reduce the morbidity and economic burden... |
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