扩张型心肌病患者血清尿酸浓度的动态变化  

The dynamic changes of serum uric acid and its clinical implications in patients with idiopathic dilated cardiomyopathy

作　　者：邰晓霞[1] 

机构地区：[1]苏州市第二人民医院心内科

出　　处：《临床心血管病杂志》2001年第3期106-107,共2页Journal of Clinical Cardiology

摘　　要：目的 :探讨扩张型心肌病 ( DCM)心力衰竭 (心衰 )患者血清尿酸浓度的变化规律及其临床意义。方法 :比较 DCM( 4 6例 )不同心功能状态下尿酸浓度 ;比较 2 2例 DCM心衰控制前后的尿酸浓度 ;比较 DCM中左室内径≥ 65mm ( 2 6例 )和 <65mm ( 1 6例 )患者的尿酸浓度 ;比较DCM入院时未用利尿剂及正在服用利尿剂患者的尿酸浓度 ;比较 DCM中血尿素氮 >7.5( 1 8例 )和≤ 7.5mmol/L( 2 8例 )患者的尿酸浓度。结果 :DCM心功能 、 、 级的尿酸分别为 ( 30 3±34)、( 4 0 3± 95)和 ( 595± 1 90 ) mmol/L;心衰控制前后尿酸浓度为〔( 60 9± 2 1 8)和 ( 4 1 4± 1 47)mmol/L( P <0 .0 1 )〕;左室内径≥ 65mm者尿酸明显高于 <65mm者 ;入院时服与未服利尿剂者尿酸无明显差异 ( P >0 .0 5) ;血尿素氮 >7.5与≤ 7.5mmol/L者尿酸浓度无明显差别 ( P >0 .0 5)。结论 :DCM心衰患者尿酸浓度增高 ,独立于服用利尿剂及肾功能不全 ,且随着心衰加重而明显增高 。Objective:To assess the change rules and clinical implications of increased serum uric in patients with idiopathic dilated cardiomyopathy (IDC).Method:The studied population consisted of 46 patients with IDC.Serum uric acid was assessed in the following groups:① Forty six patients with different severity of heart failure;②Twenty two cases before and after the control of heart failare;③Left ventricular internal diameter (LVID) ≥ or <65 mm(n=26, 16, respectively);④Patients with and without diuretic therapy;⑤Twenty eight patients with blood urea nitrogen > or ≤ 7.5 mmol/L.Result:The concentration of serum uric acid in patients NYHA functional class Ⅱ、Ⅲ、Ⅳ was (303±34), (403±95) and (595±190) mmol/L respectively.Serum uric acid wass (609±218) and (414±147) mmol/L before/after stabilization of heart failure (P< 0.01 ).It was much higher in patients whose LVID≥65 mm as compared to those LVID<65 mm (572±182 vs 425±112, P< 0.01 ).There was no difference between the patients who received diuretics or not (533±21 vs 501±16, P> 0.05 ).BUN also did not influence serum uric acid.Conclusion:The increased serum uric acid is associated with deterioration of heart failure in patients with IDC and independent of diuretics therapy or renal function insufficiency.It is a predicator of the severity of heart failure.

关 键 词：扩张型心肌病 充血性 尿酸 心力衰竭 浓度 

分 类 号：R542.2[医药卫生—心血管疾病]