慢性心力衰竭患者血尿酸水平与左室质量指数、QRS间期相关性研究  

The study of association of serum uric acid level with left ventricular mass and QRS duration in patients with chronic heart failure

作　　者：刘砂 郭敏[1] 

机构地区：[1]新疆维吾尔自治区人民医院心血管内科,乌鲁木齐830001

出　　处：《中国医师杂志》2017年第5期721-724,728,共5页Journal of Chinese Physician

摘　　要：目的通过对慢性心力衰竭患者血尿酸（UA）水平与左室质量指数（LVMI）、心电图QRS问期的相关性研究，探讨血尿酸水平是否与心肌肥厚、心室重塑及心室电机械活动非同步化相关。方法选取慢性心力衰竭患者453例作为研究对象，所有入选患者均接受心脏彩色多普勒超声、十二导联同步体表心电图、血生化及血常规检测。将UA、LVMI、QRS间期、左室射血分数（LVEF）等作为研究指标。根据UA水平不同分组：组Ⅰ，UA≤360μmol／L；组Ⅱ，360μmol／L〈UA≤420μmol／L；组Ⅲ，420μmot／L〈UA≤480μmol／L；组Ⅳ，480μmol／L〈UA≤540μmol／L；组V，UA〉540μmol／L。各组之间进行相关指标比较。结果根据患者UA值分组，从组Ⅰ至组V，随着UA值升高，LVMI值增高，五组的LVMI值比较差异有统计学意义[分别为（93．89±30．25）g／m^2，（94．44±32．46）g／m^2，（101．04±37．22）g／m^2，（124．39±63．22）g／m^2，（133．51±41．85）g／m^2]（F=17．501，P〈0．01），血尿酸水平与LVMI呈正相关（r=0．329，P〈0．01）。根据患者UA值分组，从组Ⅰ至组V，随着UA值升高，QRS间期延长，五组的QRS间期比较差异有统计学意义[分别为（93．10±14．56）ms，（92．77±21．12）ms，（94．00±19．95）ms，（97．55±20．37）ms，（101．73±25．57）ms]（F=2．516，P〈0．05）；UA水平与QRS间期呈正相关（r=0．167，P〈0．01）。根据患者UA值分组，从组Ⅰ至组Ⅴ，随着UA值升高，LVEF值降低[分别为（54．94±10．26）％，（53．06±13．43）％，（51．79±14．01）％，（45．82±13．90）％，（43．76±12．01）％]（F=14．299，P〈0．01），心功能Ⅳ级所占比例增高（分别为3．85％，4．29％，4．00％，21．05％，67．11％）（x^2=326．566，P〈0．01）。结论慢性心力衰竭患者随着血尿酸水平增高，LVMI值增大，QRS间期延长，LVEF降低，心功能�Objective To investigate the association of serum uric acid （UA） level with ventricular hypertrophy, ventricular remodeling, and ventricular electromeehanical activity dyssynchrony in patients with chronic heart failure by studying the correlation among left ventrieular mass index （LVMI） , QRS duration （QRSd） and UA . Methods Four hundred and fifty-three patients were selected in this study. Each patient received examinations of echocardiography, electrocardiogram （ECG） , blood routine, and blood bi- ochemistry. According to the different UA level, the patients were divided into group Ⅰ （UA≤360 μmol/ L）, group Ⅱ （360 μmol/L 〈 UA≤420 μmol/L）, group Ⅲ （420 μmol/L 〈 UA≤480 μmol/L）, group Ⅳ （480 μmol/L 〈 UA ≤540 μmol/L） , and group V （UA 〉 540 μmol/L）. The differences in LVMI, QRSd, Left ventricular ejection fraction （LVEF） , and NYHA class among five groups were compared, and the correlation among LVMI, QRSd and UA were analyzed. Results According to the different UA, from groups I to V, with increase in UA, LVMI values increased, there was significant difference among five groups [ （93.89 ± 30. 25 ） g/m2, （94.44 ± 32. 46） g/m2, （ 101.04 ± 37.22） g/m2, （ 124. 39 ± 63.22 ） g/ m2, and （ 133.51 ± 41.85 ） g/m2, respectively ] （ F = 17. 501, P 〈 0. 01 ）. UA level correlated positively with LVMI （r = 0. 329 P 〈0. 01 ）. According to the different UA,from groups l to V,with increase in UA,QRSd prolonged, there was significant difference among five groups [ （ 93.10 ± 14. 56 ） ms, （ 92. 77 ± 21.12） ms, （94. 00 ± 19.95） ms, （97.55 ± 20. 37 ） ms, and （ 101.73 ± 25.57 ） ms, respeetively] （ F = 2. 516,P 〈 0.05）. UA level correlated positively with QRSd （ r = 0. 167, P 〈 0. 01 ）. Aecording to the dif- ferent UA , from groups I to V, with increase in UA, LVEF was reduced [ （54.94 ± 10. 26）% , （53.06 ±13.43）%,（51.79±14.01）%, （45.82±13.90）%, and （43.76±12.01）%, resp

关 键 词：心力衰竭 尿酸/代谢 人体质量指数 心室功能 左 心电描记术 

分 类 号：R541.6[医药卫生—心血管疾病]