首页> 中文期刊>中国循证心血管医学杂志 >扩张型心肌病继发肺动脉高压与血尿酸的相关性研究

扩张型心肌病继发肺动脉高压与血尿酸的相关性研究

     

摘要

目的 研究扩张型心肌病(DCM)继发肺动脉高压与血尿酸的相关性.方法 回顾性分析武汉大学中南医院心内科自2012年1月1日~2016年4月14日间住院的113例扩张型心肌病患者资料,其中男性85例,女性28例.根据肺动脉压水平将入组患者分为肺动脉高压组(62例)和非肺动脉高压组(51例).所有患者入院后收集一般资料,并检测血尿酸(sUA)、肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTnI)、谷草转氨酶(AST)、谷丙转氨酶(ALT)、尿素氮(BUN)、肌酐(Cr)、红细胞分布宽度(RDW)、高敏C反应蛋白(hs-CRP)及心脏彩超检测的指标包括升主动脉宽度、肺动脉宽度、左心房内径值、左心室内径值、室间隔厚度、左室后壁厚度、左室射血分数(LVEF),比较两组一般资料、生化指标及心脏超声结果 .结果 两组基本资料比较分析,肺动脉高压组的年龄高于非肺动脉高压组;肺动脉高压组的尿酸、尿素氮、红细胞分布宽度均高于非肺动脉高压组,差异有统计学意义(P均<0.05).两组心脏彩超测量指标比较分析,肺动脉高压组的左心房内径值高于非肺动脉高压组,差异有统计学意义(P<0.05).两组样本行单因素相关分析后筛选出心肌酶、尿素氮、尿酸、红细胞分布宽度、年龄、左心房内径值可能与肺动脉高压有相关性,后根据筛选的因素,行Logistic回归分析,结果 提示血尿酸(OR=1.009,95%CI:1.004~1.015,P<0.05)、年龄(OR=1.048,95%CI:1.003~1.095,P<0.05)、左心房内径值(OR=1.111,95%CI:1.023~1.207,P<0.05)与扩张型心肌病肺动脉高压的发生有明显正相关.结论 扩张型心肌病患者继发肺动脉高压可能与尿酸升高、左心房扩大、年龄增加相关,可能作为临床考虑扩张型心肌病患者肺动脉高压形成的危险因素.%Objective To study the correlation between secondary pulmonary arterial hypertension (PAH) and blood uric acid (BUA) in patients with dilated cardiomyopathy (DCM).Methods The data of DCM patients (n=113, male 85 and female 28), hospitalized in the Department of Cardiology of Zhongnan Hospital affiliated to Wuhan University, were retrospectively analyzed from Jan. 1, 2012 to Apr. 14, 2016. All patients were divided, according to the level of pulmonary arterial pressure, into PAH group (n=62) and non-PAH group (n=51). The general data was collected from all patients, and indexes of blood uric acid (BUA), creatine kinase MB (CK-MB), cardiac troponin I (cTnI), aspertate aminotransferase (AST), alanine aminotransferase (ALT), blood urea nitrogen (BUN), serum creatinine (SCr), red blood cell distribution width (RDW) and high-sensitivity C-reactive protein (hs-CRP) were detected after patients were hospitalized. The indexes of ascending aorta width, pulmonary artery width, left atrial diameter (LAD), left ventricular diameter (LVD), interventricular septal thickness (IVST), left ventricular posterior wall thickness (LVPWT) and left ventricular ejection fraction (LVEF) were detected by using color Doppler ultrasonography. The general data, biochemical indexes and results of color Doppler ultrasonography were compared between 2 groups.Results The age, BUA, BUN and RDW were higher in PAH group than those in non-PAH group (allP<0.05). LAD was higher in PAH group than that in non-PAH group (P<0.05). The single-factor correlation analysis showed that myocardial enzyme, BUN, BUA, RDW, age and LAD might by correlated to PAH. The results of Logistic regression analysis showed that BUN (OR=1.009, 95%CI: 1.004~1.015,P<0.05), age (OR=1.048, 95%CI: 1.003~1.095,P<0.05) and LAD (OR=1.111, 95%CI: 1.023~1.207,P<0.05) were positively correlated to PAH.Conclusion The secondary PAH may be related to the increases of BUA, LAD and age, which can be taken as the risk factors of PAH onset in DCM patients.

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