CAR、尿酸与早发心肌梗死相关性的研究进展
Research Progress on the Correlation between CAR, Uric Acid, and Premature Myocardial Infarction
DOI: 10.12677/jcpm.2025.45460, PDF,   
作者: 李佳洋：济宁医学院临床医学院，山东 济宁；包金丽*：枣庄市立医院心内科，山东 枣庄
关键词: C反应蛋白与白蛋白比值；尿酸；早发心肌梗死；Ratio of C-Reactive Protein to Albumin； Uric Acid； Early-Onset Myocardial Infarction
摘要: 人类的生活水平和医疗水平越来越高，但一些疾病的发病年龄越来越年轻化，例如：心肌梗死。生物标志物在心肌梗死的诊断和病情评估中被广泛使用，而作为新兴的生物标志物，C反应蛋白(CRP)与白蛋白(ALB)的比率(CAR)和尿酸(UA)对心肌梗死的早期发现、病情严重程度的评估和预后评估都起着重要作用。通过对CAR和尿酸的检测，可以及早识别和治疗早发心肌梗死患者，有助于改善临床结局，显著减少病死率。
Abstract: The living standards and medical levels of humans are getting higher and higher, but the onset age of some diseases, such as myocardial infarction, is becoming younger. Biomarkers are widely used in the diagnosis and disease assessment of myocardial infarction. As emerging biomarkers, the ratio of C-reactive protein (CRP) to albumin (ALB) (CAR) and uric acid (UA) play an important role in the early detection of myocardial infarction, assessment of disease severity, and prognosis evaluation. By detecting CAR and uric acid, early-onset myocardial infarction patients can be identified and treated early, which helps to improve clinical outcomes and significantly reduce mortality.
文章引用：李佳洋, 包金丽. CAR、尿酸与早发心肌梗死相关性的研究进展[J]. 临床个性化医学, 2025, 4(5): 58-66. https://doi.org/10.12677/jcpm.2025.45460

参考文献

[1] Jokinen, E. (2015) Obesity and Cardiovascular Disease. Minerva Pediatr, 67, 25-32.
[2] 朱丽娜, 朱瑛, 王琼, 等. 早发冠心病与基因多态性的相关研究进展[J]. 广州医药, 2025, 56(3): 310-315.
[3] 陈润林, 廖江波, 皮建彬, 等. 早发冠心病危险因素分析及列线图模型构建[J]. 现代医学, 2025, 53(4): 522-529.
[4] 孙宇阳, 刘晓丽, 韩红亚, 等. 早发冠心病合并抑郁的现状及研究进展[J]. 中国医药, 2025, 20(2): 288-292.
[5] Byrne, R.A., Rossello, X., Coughlan, J.J., Barbato, E., Berry, C., Chieffo, A., et al. (2023) 2023 ESC Guidelines for the Management of Acute Coronary Syndromes. European Heart Journal: Acute Cardiovascular Care, 13, 55-161. [Google Scholar] [CrossRef] [PubMed]
[6] Chien, S., Chen, C., Leu, H., Su, C., Yin, W., Tseng, W., et al. (2017) Association of Low Serum Albumin Concentration and Adverse Cardiovascular Events in Stable Coronary Heart Disease. International Journal of Cardiology, 241, 1-5. [Google Scholar] [CrossRef] [PubMed]
[7] GBD 2019 Diseases and Injuries Collaborators (2020) Global Burden of 369 Diseases and Injuries in 204 Countries and Territories, 1990-2019: A Systematic Analysis for the Global Burden of Disease Study 2019. The Lancet, 396, 1204-1222.
[8] Rona, G. (1966) The Pathogenesis of Human Myocardial Infarction. Canadian Medical Association Journal, 95, 1012-1019.
[9] Falk, E. (2006) Pathogenesis of Atherosclerosis. Journal of the American College of Cardiology, 47, C7-C12. [Google Scholar] [CrossRef] [PubMed]
[10] Bentzon, J.F., Otsuka, F., Virmani, R. and Falk, E. (2014) Mechanisms of Plaque Formation and Rupture. Circulation Research, 114, 1852-1866. [Google Scholar] [CrossRef] [PubMed]
[11] 冯世华, 朱国斌, 王瑾. 45岁以下人群急性心肌梗死危险因素的研究进展[J]. 中西医结合心脑血管病杂志, 2023, 21(24): 4554-4557.
[12] Lawler, P.R., Bhatt, D.L., Godoy, L.C., Lüscher, T.F., Bonow, R.O., Verma, S., et al. (2021) Targeting Cardiovascular Inflammation: Next Steps in Clinical Translation. European Heart Journal, 42, 113-131. [Google Scholar] [CrossRef] [PubMed]
[13] Buerke, M., Sheriff, A. and Garlichs, C.D. (2022) CRP-Apherese bei akutem myokardinfarkt bzw. COVID-19. Medizinische Klinik-Intensivmedizin und Notfallmedizin, 117, 191-199. [Google Scholar] [CrossRef] [PubMed]
[14] Moroni, F., Corna, G., Del Buono, M.G., Golino, M., Talasaz, A.H., Decotto, S., et al. (2024) Impact of C-Reactive Protein Levels and Role of Anakinra in Patients with St-Elevation Myocardial Infarction. International Journal of Cardiology, 398, Article 131610. [Google Scholar] [CrossRef] [PubMed]
[15] Zhang, S., Xu, W., Xu, J., Qiu, Y., Wan, Y. and Fan, Y. (2024) Association of C-Reactive Protein Level with Adverse Outcomes in Patients with Atrial Fibrillation: A Meta-Analysis. The American Journal of the Medical Sciences, 367, 41-48. [Google Scholar] [CrossRef] [PubMed]
[16] 殷宇刚, 陈祥俊. 老年同型半胱氨酸与C反应蛋白水平与冠心病发病的相关性[J]. 山东医药, 2010, 50(49): 71-72.
[17] 金旭, 张立晶. C-反应蛋白联合肌钙蛋白I检测在急性冠状动脉综合征诊断中的应用[J]. 中国现代医学杂志, 2010, 20(23): 3671-3673.
[18] Rothschild, M.A., Oratz, M. and Schreiber, S.S. (1969) Serum Albumin. The American Journal of Digestive Diseases, 14, 711-744. [Google Scholar] [CrossRef] [PubMed]
[19] Yoshioka, G., Tanaka, A., Nishihira, K., Shibata, Y. and Node, K. (2020) Prognostic Impact of Serum Albumin for Developing Heart Failure Remotely after Acute Myocardial Infarction. Nutrients, 12, Article 2637. [Google Scholar] [CrossRef] [PubMed]
[20] Manolis, A.A., Manolis, T.A., Melita, H., Mikhailidis, D.P. and Manolis, A.S. (2022) Low Serum Albumin: A Neglected Predictor in Patients with Cardiovascular Disease. European Journal of Internal Medicine, 102, 24-39. [Google Scholar] [CrossRef] [PubMed]
[21] Ronit, A., Kirkegaard-Klitbo, D.M., Dohlmann, T.L., Lundgren, J., Sabin, C.A., Phillips, A.N., et al. (2020) Plasma Albumin and Incident Cardiovascular Disease: Results from the CGPS and an Updated Meta-Analysis. Arteriosclerosis, Thrombosis, and Vascular Biology, 40, 473-482. [Google Scholar] [CrossRef] [PubMed]
[22] Huang, T., An, Z., Huang, Z., Gao, W., Hao, B. and Xu, J. (2024) Serum Albumin and Cardiovascular Disease: A Mendelian Randomization Study. BMC Cardiovascular Disorders, 24, Article No. 196. [Google Scholar] [CrossRef] [PubMed]
[23] Kurniawan, R.B., Oktafia, P., Saputra, P.B.T., Purwati, D.D., Saputra, M.E., Maghfirah, I., et al. (2024) The Roles of C-Reactive Protein-Albumin Ratio as a Novel Prognostic Biomarker in Heart Failure Patients: A Systematic Review. Current Problems in Cardiology, 49, Article 102475. [Google Scholar] [CrossRef] [PubMed]
[24] Sabanoglu, C. and Inanc, I.H. (2022) C-Reactive Protein to Albumin Ratio Predicts for Severity of Coronary Artery Disease and Ischemia. European Review for Medical and Pharmacological Sciences, 26, 7623-7631.
[25] Kalyoncuoglu, M. and Durmus, G. (2020) Relationship between C-Reactive Protein-To-Albumin Ratio and the Extent of Coronary Artery Disease in Patients with Non-St-Elevated Myocardial Infarction. Coronary Artery Disease, 31, 130-136. [Google Scholar] [CrossRef] [PubMed]
[26] Liu, D., Yun, Y., Yang, D., Hu, X., Dong, X., Zhang, N., et al. (2019) What Is the Biological Function of Uric Acid? An Antioxidant for Neural Protection or a Biomarker for Cell Death. Disease Markers, 2019, Article ID: 4081962. [Google Scholar] [CrossRef] [PubMed]
[27] Cai, W., Duan, X., Liu, Y., Yu, J., Tang, Y., Liu, Z., et al. (2017) Uric Acid Induces Endothelial Dysfunction by Activating the HMGB1/RAGE Signaling Pathway. BioMed Research International, 2017, Article ID: 4391920. [Google Scholar] [CrossRef] [PubMed]
[28] Cheng, Z., Zheng, T., Zhang, D., Yang, J., Hu, X., Yin, C., et al. (2021) High-Level Uric Acid in Asymptomatic Hyperuricemia Could Be an Isolated Risk Factor of Cardio-Cerebrovascular Diseases: A Prospective Cohort Study. Nutrition, Metabolism and Cardiovascular Diseases, 31, 3415-3425. [Google Scholar] [CrossRef] [PubMed]
[29] Yin, W., Zhou, Q., OuYang, S., Chen, Y., Gong, Y. and Liang, Y. (2019) Uric Acid Regulates NLRP3/Il-1β Signaling Pathway and Further Induces Vascular Endothelial Cells Injury in Early CKD through ROS Activation and K+ Efflux. BMC Nephrology, 20, Article No. 319. [Google Scholar] [CrossRef] [PubMed]
[30] Wang, K., Zhang, Y., Zhou, M., Du, Y., Li, P., Guan, C., et al. (2023) HDAC Inhibitors Alleviate Uric Acid-Induced Vascular Endothelial Cell Injury by Way of the HDAC6/FGF21/PI3K/AKT Pathway. Journal of Cardiovascular Pharmacology, 81, 150-164. [Google Scholar] [CrossRef] [PubMed]
[31] Sultana, S., K, M.S., Prakash, V.R., Karthikeyan, A., Aslam S, S.M., C, S.G., et al. (2023) Evaluation of Uric Acid to Albumin Ratio as a Marker of Coronary Artery Disease Severity in Acute Coronary Syndrome: A Cross-Sectional Study. Cureus, 15, e49454. [Google Scholar] [CrossRef] [PubMed]
[32] Rothenbacher, D., Kleiner, A., Koenig, W., Primatesta, P., Breitling, L.P. and Brenner, H. (2012) Relationship between Inflammatory Cytokines and Uric Acid Levels with Adverse Cardiovascular Outcomes in Patients with Stable Coronary Heart Disease. PLOS ONE, 7, e45907. [Google Scholar] [CrossRef] [PubMed]
[33] Strazzullo, P. and Puig, J.G. (2007) Uric Acid and Oxidative Stress: Relative Impact on Cardiovascular Risk. Nutrition, Metabolism and Cardiovascular Diseases, 17, 409-414. [Google Scholar] [CrossRef] [PubMed]
[34] Purnima, S. and El-Aal, B.G.A. (2016) Serum Uric Acid as Prognostic Marker of Coronary Heart Disease (CHD). Clínica e Investigación en Arteriosclerosis, 28, 216-224. [Google Scholar] [CrossRef] [PubMed]
[35] Kleber, M.E., Delgado, G., Grammer, T.B., Silbernagel, G., Huang, J., Krämer, B.K., et al. (2015) Uric Acid and Cardiovascular Events: A Mendelian Randomization Study. Journal of the American Society of Nephrology, 26, 2831-2838. [Google Scholar] [CrossRef] [PubMed]
[36] Gayretli Yayla, K., Yayla, C., Erdol, M.A., Karanfil, M., Ertem, A.G. and Akcay, A.B. (2021) Relationship between C-Reactive Protein to Albumin Ratio and Infarct-Related Artery Patency in Patients with St-Segment Elevation Myocardial Infarction. Angiology, 73, 260-264. [Google Scholar] [CrossRef] [PubMed]
[37] Cirakoglu, O.F., Aslan, A.O., Yilmaz, A.S., Şahin, S. and Akyüz, A.R. (2020) Association between C-Reactive Protein to Albumin Ratio and Left Ventricular Thrombus Formation Following Acute Anterior Myocardial Infarction. Angiology, 71, 804-811. [Google Scholar] [CrossRef] [PubMed]
[38] Zhang, S., Wang, Y., Cheng, J., Huangfu, N., Zhao, R., Xu, Z., et al. (2019) Hyperuricemia and Cardiovascular Disease. Current Pharmaceutical Design, 25, 700-709. [Google Scholar] [CrossRef] [PubMed]
[39] Rong, J., Fang, C., Chen, X., Hong, C. and Huang, L. (2023) Association of Serum Uric Acid with Prognosis in Patients with Myocardial Infarction: An Update Systematic Review and Meta-Analysis. BMC Cardiovascular Disorders, 23, Article No. 512. [Google Scholar] [CrossRef] [PubMed]
[40] Shen, S., He, F., Cheng, C., Xu, B. and Sheng, J. (2021) Uric Acid Aggravates Myocardial Ischemia-Reperfusion Injury via ROS/NLRP3 Pyroptosis Pathway. Biomedicine & Pharmacotherapy, 133, Article 110990. [Google Scholar] [CrossRef] [PubMed]
[41] Wu, H., Dai, R., Wang, M. and Chen, C. (2023) Uric Acid Promotes Myocardial Infarction Injury via Activating Pyrin Domain-Containing 3 Inflammasome and Reactive Oxygen Species/Transient Receptor Potential Melastatin 2/Ca2+Pathway. BMC Cardiovascular Disorders, 23, Article No. 10. [Google Scholar] [CrossRef] [PubMed]
[42] Park, J., Noh, J., Kim, J., Lee, H., Kim, K. and Park, J. (2022) Gene Dose-Dependent and Additive Effects of ABCG2 Rs2231142 and SLC2A9 Rs3733591 Genetic Polymorphisms on Serum Uric Acid Levels. Metabolites, 12, Article 1192. [Google Scholar] [CrossRef] [PubMed]