摘要选择安康市中医医院2017年10月至2019年10月接诊的120例冠状动脉（冠脉）临界病变患者作为观察组，另选同期的120例心电图有明确缺血性改变，但冠脉造影明确无狭窄者作为对照组，比较两组血清尿酸（SUA）、1-磷酸鞘氨醇（S1P）水平、Gensini评分及高危因素。以冠脉血流储备分数（FFR)≤0.8作为诊断功能性心肌缺血的标准，对观察组冠脉临界病变患者确诊功能性心肌缺血和未确诊功能性心肌缺血患者各项指标进行单因素方差分析。使用Pearson法分析SUA、S1P水平与Gensini评分间的相关性。结果显示，观察组SUA[（492.52±35.47）μmol/L]、S1P水平[（386.42±46.19）nmol/L]和Gensini评分[（69.42±7.81）分]均明显高于对照组，差异均有统计学意义（ t值分别为51.218、35.227、60.237， P<0.05)；观察组确诊为功能性心肌缺血患者SUA[（678.23±54.21）μmol/L]、SIP[（483.45±34.64）nmol/L]和Gensini评分[（83.22±5.34）分]及长期吸烟(100.00%,39/39)、饮酒(64.01%，25/39)、高血压(100.00%，39/39)、糖尿病(82.05%,32/39)、血脂异常（100.00%,39/39）的发生率显著高于未确诊者，差异均有统计学意义（ t值分别为24.764、18.858、17.888，χ 2值分别为55.883、53.684、27.819、71.070、31.111， P<0.05）。经Pearson法分析,冠脉临界病变患者血清SUA、S1P水平均与Gensini评分呈正相关（ r值分别为0.653、0.715， P<0.01）。提示冠脉临界病变患者SUA、S1P水平越高，冠脉狭窄程度越严重，且功能性心肌缺血患者中SUA、S1P水平更高。

abstractsA total of 120 patients with intermediate coronary artery disease who were admitted to Ankang Hospital of Traditional Chinese Medicine from October 2017 to October 2019 were enrolled in the study (study group), and 120 patients who had ischemic changes on ECG, but no definite angiographic stenosis served as the control group. The SUA and S1P levels were measured, and Gensini scores were evaluated. Coronary blood flow reserve fraction (FFR)≤0.8 was used as the gold standard for diagnosis of functional myocardial ischemia. Patients in the observation group with functional myocardial ischemia and no-functional myocardial ischemia were evaluated. The correlation between variables was analyzed using the Pearson method. The levels of SUA [(492.52±35.47)μmol/L], S1P [(386.42±46.19)nmol/L] and Gensini score (69.42±7.81) in the study group were significantly higher than those in the control group ( t=51.218, 35.227, 60.237; P<0.05).In the study group, patients with functional myocardial ischemia had higher SUA[(678.23±54.21)μmol/L], SIP[(483.45±34.64)nmol/L] and Gensini score[(83.22±5.34) points], and higher incidence of drinking, hypertension, diabetes, and hyperlipidemia compared with no-functional myocardial ischemia patients ( t=24.764, 18.858, 17.888, respectively; χ 2=55.883, 53.684, 27.819, 71.070, 31.111, respectively; P<0.05). Pearson analysis showed that levels of SUA and S1P in patients with coronary artery lesions were positively correlated with Gensini score ( r=0.653, 0.715; P<0.01). The levels of SUA and S1P in patients with intermediate coronary artery lesions are correlated with the severity of coronary stenosis, the combination of the two indicators has better efficacy in predicting functional myocardial ischemia.