The Correlation Analysis Of Serum Uric Acid Level With The Degree Of Coronary Artery Disease And The Constitution Of Traditional Chinese Medicine

ObjectivesTo study the correlation between the degree of coronary artery stenosis and the level of serum uric acid by the results of coronary arteriography,to preliminarily investigation the level of serum uric acid in patients with coronary heart disease with different Constitution of Traditional Chinese Medicine(TCM),in order to improve the clinical value of blood uric acid in patients.To provide clinical basis for the occurrence,development,treatment and prognosis of coronary heart disease in the patient of different Traditional Chinese Medicine.MethodsCollected 540 patients with suspected coronary heart disease and acception coronary angiography during hospitalization in the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine from December 2016to December 2017.Recorded the experimental date of fasting blood test of serum uric acid level,blood lipid level(including total cholesterol,triglyceride,high-density lipoprotein,low density lipoprotein)in the patient,and the situation of hypertension,diabetes and smoking history.Determination of TCM Constitution was based on the questionnaire of《The criteria of TCM Constitution Classification》issued by China Association of China Medicine in 2009.Including nine simplex constitution types in this publication:phlegm-dampness constitution,dampness-heat constitution,qi-stagnation constitution,qi-deficiency constitution,blood-stasis constitution,yin-deficiency constitution,yang-deficiency constitution,special constitution,and normal quality.The definition of the composition constitution was compresenced by two types simplex constitution.Phlegm dampness and blood stasis,qi stagnation and blood stasis,qi deficiency and blood stasis,damp heat and blood stasis,qi deficiency and phlegm dampness,yang deficiency and blood stasis and qi and yin deficiency in our sample.Phlegm dampness and blood stasis,qi stagnation and blood stasis,qi deficiency and blood stasis,damp heat and blood stasis,qi deficiency and phlegm dampness,phlegm-dampness,dampness-heat,qi-stagnation be included in our statistics since some constitution sample were shortaged.Seilinger’s method of coronary ateryiography was used,and right radial artery was the main part of the puncture site,a few patients were punctured by the left radial artery or the right femoral artery.Observed left main trunk(LM),left anterior descending artery(LAD),left circumflex artery(LCX),right coronary artery(RCA)and branches according to the method of routine position by projection.Recording the location,area stenosis,length of lesion,collateral circulation,thrombus,calcification,bifurcation lesion type,whether the diffuse lesions and the involved segment number.To evaluate the degree of coronary artery disease by entering the Syntax integral website.Reference to asymptomatic hyperuricemia diagnosis and treatment of cardiovascular disease by Chinese expert consensus in 2009 evaluated the level of serum uric acid standard:definition of hyperuricemia was non two day fasting serum uric acid level:male>420μmol/L(7mg/dL)and female>357μmol/L(6mg/dL)under normal purine diet.The definition of dyslipidemia:total cholesterol>5.18mmol/L,triglyceride>1.7mmol/L,high density lipoprotein<1.04mmol/L,low density lipoprotein>3.37mmol/L.The definition of history of smoking:smoke at least 1 cigarette everyday,and to continue or to accumulate 6 months or more than 6 months.Age section:the experiment is divided into four age groups:44 years old,45-59 years old,60-74 years old,75 years old according to the new age of the United Nations WHO proposed segmentation.Statistical methods:SPSS 22 statistical software was used to deal the figures:Two Logistic regression analysis for correlation of risk factors of coronary heart disease with serum uric acid.T test was used to verify whether statistically significant between the average of two groups of serum uric acid value.The relationship between uric acid and the number of lesions was analyzed by one-way ANOVA and LSD-T test.The correlation between the degree of coronary artery disease and uric acid level and the constitution of different types of Chinese medicine in different gender and age groups were analyzed.Chi square test was used to detect the difference of constitution fitness between the experimental group and the control group.Results1.The detection rate of hyperuricemia(53.0%)and average value(396.91±104.82)in CHD group were significantly higher than those in non CHD group(26.7%)and mean value(358.17±72.19)(P<0.05)by the result of the comparison between coronary heart disease group and non coronary heart disease group.The serum uric acid level of patients with coronary heart disease was positively correlated with the Syntax score(F=78.274,P=0.000),R~2=0.208,and the regression equation was Y=2.757X+0.028.2.The syntax score from low to high were single branch group<double branch group<three branch group.But in the single lesion group,women>men;in the double lesion group and three lesion group,men>women.The level of serum uric acid was different between the branches of different lesions,The level of serum uric acid in three lesions was significantly higher than that in single vessel disease(P<0.05),but there was no difference in serum uric acid level between single lesion group and control group and double lesion group,double lesion group and three lesion group(P>0.05).3.Different degrees of lesions was showed in different age groups,With the increase of age,the degree of pathological changes gradually increased(P<0.05),but there was no significant difference in the level of blood uric acid(P>0.05).The age of the patients with complex constitution was fastened on the age of 60-74 years,but there was no statistical difference in the specific classification of TCM constitution(P>0.05).4.The level of serum uric acid is one of the factors risk in the constitution of traditional Chinese medicine.The level of serum uric acid in patients with composite constitution was higher than that in simplex constitution,from high to low in turn:damp heat and blood stasis constitution,phlegm dampness constitution,qi deficiency and blood stasis constitution,qi deficiency and phlegm dampness,qi stagnation and blood stasis constitution.The level of the serum uric acid of patients with coronary heart disease was higher than the patients with non coronary heart disease,from high to low:damp heat and blood stasis constitution>qi deficiency and phlegm dampness constitution>phlegm dampness and blood stasis constitution>qi deficiency and blood stasis constitution>qi stagnation and blood stasis constitution>phlegm-dampness constitution>dampness-heat constitution>qi-stagnation constitution.Comparison between groups was statistically significant(P<0.05).The level of uric acid in damp heat and blood stasis constitution in each two groups was significantly higher than that of other constitution(P<0.05).The level of the patient of the coronary heart disease with hyperuricemia was higher than the patient with non coronary heart disease but the level of the serum uric acid was normal,damp heat and blood stasis constitution>phlegm dampness and blood stasis constitution>qi deficiency and blood stasis constitution>qi deficiency and phlegm dampness constitution>qi stagnation and blood stasis constitution>phlegm-dampness constitution>dampness-heat constitution>qi-stagnation constitution(P<0.05).The level of the serum uric acid of qi-stagnation constitution was lower than other constitution after comparison of each group(P<0.05).5.Patients with coronary heart disease have more composite constitution,no matter with or without hyperuricemia,the highest detection rate was damp heat and blood stasis constitution.Non coronary patients with more simplex constitution,the detection rate of phlegm-dampness constitution was the highest.(P<0.05).6.The degree of coronary artery disease in patients with different constitution was different,the most serious was patients with qi deficiency and blood stasis constitution(P<0.05).Double branch and three branches lesions was in the majority in the group of the coronary heart disease with hyperuricemia in composite constitutions,The most serious degree was qi deficiency and blood stasis constitution.Single branch lesion was in the majority in simplex constitutions.The most serious degree was dampness-heat constitution(P<0.05).Conclusion1.The level of serum uric acid is one of risk factors in coronary heart disease,but not independent factor.2.The serum uric acid level of male patients with coronary heart disease is higher than that of female,and the degree of lesion is more serious.3.The compound constitution is more than the single constitution in the coronary heart disease with or without hyperuricemia,and the highest level of serum uric acid in patients with damp heat and blood stasis constitution.4.The complex constitution of male coronary heart disease patients is more than that of female,and the degree of coronary artery disease is more serious.The patient with coronary heart disease with or without hyperuricemia with qi deficiency and blood stasis constitution has most serious degree of artery disease.