血尿酸检测在慢性心衰患者临床症状评估上的应用  

Relationship between cardiac function and serum uric acid level in patients with chronic heart failure

作　　者：唐帅[1] 李林峪[2] 

机构地区：[1]梁平县人民医院内二科,重庆405200 [2]解放军第三军医大学西南医院心内科,重庆400038

出　　处：《临床军医杂志》2013年第12期1231-1233,共3页Clinical Journal of Medical Officers

摘　　要：目的探讨血尿酸在慢性心力衰竭（CHF）患者体内的分布水平，以及与临床症状严重程度的关系。方法将我院393例CHF患者按随机数字表法选择出CHF患者69例，进而按照NYHA分级标准，分为心功能Ⅰ～Ⅱ级组23例，心功能Ⅲ级组26例，心功能Ⅳ级组20例，同时选取25例无任何疾患的健康体检者为对照组。采用全自动生化分析仪，对健康对照者和慢性心衰患者进行血尿酸含量测定，并与左室射血分数（LVEF）以及二尖瓣瓣尖水平的E峰和A峰最大速度比（E／A）进行相关性分析。结果健康对照组血尿酸含量为（239．72±102．31）μmol／L，CHF患者心功能I～Ⅱ级组血尿酸含量为（323．65±108．36）μmol／L，心功能Ⅲ级组血尿酸含量为（393．61±116．37）μmot／L，心功能Ⅳ级组血尿酸含量为（435．53±98．37）μmol／L，各组间血尿酸含量差异有显著统计学意义（P〈0．01），随心衰程度的加重，血尿酸水平也显著地增加。相关性分析发现心衰患者血尿酸水平与LVEF呈显著负相关（r=-0．53，P〈0．01），与E／A也呈显著负相关（r=-0．38，P〈0．01）。结论CHF患者血清尿酸水平与心功能分级存在相关关系，可以作为评价CHF患者心功能损害程度以及临床转归的一项监测指标。Objective To investigate the relationship between cardiac function and serum uric acid （UA） level in the patients with chronic heart failure （CHF）. Methods A total of 393 patients of CHF were classified by digital meter method. The serum UA, E/A and left ventricular ejection fraction （LVEF） were measured in 69 patients with CHF and 25 normal controls. According to NYHA, there were 23 cases with Ⅰ -Ⅱ class, 26 cases with m class, 20 cases with IV class. Results The serum UA level was （239.72 ± 102.31 ） μmoL/L in control group, （323.65 ± 108.36） μmol/L in NYHA Ⅰ -Ⅱ class group, （ 393.61± 116.37 ） μmol/L in NYHA llI class group and （435.53±98.37）μmol/L in NYHA IV class group. There were significant differences in se- rum UA level among the groups （ P 〈 0.01 ）. With cardiac functional aggravating, the serum UA level increased significantly. The serum UA level in the patients was negatively correlated with LVEF （r=-0.53, P 〈 0.01 ） and E/A （r= -0.38, P 〈 0.01 ）. Conclusion Serum UA level is correlated with classification of cardiac function, and it can be used as an index to evaluate the damage degree of cardiac function, as well as the clinical outcome, in CHF patients.

关 键 词：心力衰竭 心功能 超声心动图 尿酸 

分 类 号：R541.6[医药卫生—心血管疾病]