肺心病心力衰竭患者心功能与血尿酸水平的关系

摘要

Objective To analyze the level changes of blood uric acid (BUA) and relationship between them and heart function in patients with pulmonary heart disease-heart failure (PHD-HF).Methods The patients with PHD-HF were chosen as observation group (n=95, male 64, female 31 and aged from 53 to 84) from the Department of Internal Medicine of You’anmen Hospital in Fengtai District of Beijing City from Oct. 2013 to Aug. 2015. The observation group was again divided, according to NYHA class, into class II group (n=33), class III group (n=32) and class IV group (n=30). The health controls with physical examinations at the same period were randomly chosen as control group (n=40, male 27 and female 13). The levels of BUA, partial pressure of oxygen (PaO2), left ventricular end-diastolic inner diameter (LVEDd) and left ventricular ejection fraction (LVEF) were detected in observation group after hospitalization and in control group at the day of physical examinations.Results The level of BUA was (462.7±109.5) μmol/L in observation group, which was significantly higher than that in control group (341.8± 102.1) μmol/L (P<0.01). The percentage of patients with hyperuricacidemia was higher in observation group than that in control group (55.8%vs. 27.5%,P<0.05). The levels of BUA and LVEDd were higher, and LVEF and PaO2 were lower in class III group and class IV group then those in control group and class II group (allP<0.05). The levels of BUA showed a ascending trend and PaO2 showed a descending trend in control group, class II group, class III group and class IV group (allP<0.05).Conclusion The level of BUA will increase more significantly as heart function is more poor, so BUA maybe an index for reviewing the severity of HF in patients with PHD-HF.%目的：分析慢性肺源性心脏病（肺心病）心力衰竭（心衰）患者血尿酸水平的变化及与心功能的关系。方法选择2013年10月~2015年8月于北京丰台右安门医院内科住院的肺心病心衰患者95例为观察组，其中男性64例，女性31例，年龄53~84岁。观察组再按美国纽约心脏病学会（NYHA）心功能分级标准进行分组，Ⅱ级组（33例），Ⅲ级组（32例），Ⅳ级组（30例）。随机选择同期体检的健康者40例为对照组，其中男性27例，女性13例。观察组在入院后、对照组检查当日检测血尿酸、氧分压（PaO2）、左室舒张末期内径（LVEDD）及左室射血分数（LVEF）。结果观察组血尿酸水平为（462.7±109.5）μmol/L，显著高于对照组（341.8±102.1）μmol/L，差异具有统计学意义（P＜0.01）。观察组高尿酸血症比例高于对照组（55.8%vs.27.5%），差异具有统计学意义（P＜0.05）。Ⅲ级组和Ⅳ级组血尿酸、LVEDD均高于对照组和Ⅱ级组，LVEF、PaO2均低于对照组和Ⅱ级组，差异有统计学意义（P均＜0.05）。对照组、Ⅱ级组、Ⅲ级组、Ⅳ级组血尿酸水平呈上升趋势，PaO2呈下降趋势，差异有统计学意义（P均＜0.05）。结论肺心病心力衰竭患者心功能越差，其血尿酸水平升高越明显，血尿酸水平检测可能成为评估心力衰竭严重程度的指标。