老年射血分数保留心力衰竭患者血尿酸和同型半胱氨酸水平变化与病情重程度及预后的关系  

Relationship between Serum Uric Acid and Homocysteine of Elderly Patients with Heart Failure Preserved by Ejection Fraction

作　　者：张华[1] 王萌 高华 贾江涛 ZHANG Hua;WANG Meng;GAO Hua(Department of Cardiology,Tangxian People's Hospital,Tangxian,Hebei 072350)

机构地区：[1]唐县人民医院心内科,河北唐县072350 [2]保定市第二医院,河北保定071000

出　　处：《医学临床研究》2019年第10期1957-1959,共3页Journal of Clinical Research

摘　　要：【目的】探讨老年射血分数保留心力衰竭(HFPEF)患者血尿酸(BUA)、同型半胱氨酸(Hcy)水平与病情重程度及预后的关系。【方法】选取本院收治的203例老年HFPEF患者(观察组),根据NYHA心功能分级将其分为心功能Ⅱ级组(n=72),心功能Ⅲ级组(n=75),心功能Ⅳ级组(n=56)。同时选取同期50例健康志愿者作为对照组。比较各组BUA、Hcy、N-末端B型利尿钠肽前体(NT-proBNP)、左室射血分数(LVEF)水平。随访1年,根据预后情况分为预后不良组和预后良好组,比较两组患者心功能分级情况,BUA、Hcy和NT-proBNP水平。采用ROC曲线分析BUA和Hcy预测患者预后的价值。【结果】观察组血清BUA、Hcy、NT-proBNP水平显著高于对照组,差异有统计学意义(P<0.05);LVEF水平比较,差异无统计学意义(P>0.05)。心功能Ⅳ级组血清BUA、Hcy、NT-proBNP水平最高,心功能Ⅲ级组次之,心功能Ⅱ级最低,差异均有统计学意义(P<0.05)。Pearson分析显示,血清BUA、Hcy水平与NT-proBNP均呈正相关(r分别为0.784、0.732,均P<0.05)。预后良好组患者入院时心功能分级(NYHAⅢ~Ⅳ级)比例、血清BUA、Hcy、NT-proBNP水平均低于预后不良组,差异均有统计学意义(P<0.05)。【结论】HFPEF患者血清BUA、Hcy水平显著上升,与左室功能呈正相关,对HFPEF的诊断、严重程度、预后具有一定的参考价值。【Objective】To explore the relationship between the levels of serum uric acid (BUA) and homocysteine (Hcy) and the severity of the disease and prognosis in the elderly patients with heart failure (HFPEF) preserved by ejection fraction.【Methods】A total of 203 elderly HFPEF patients (observation group) admitted to our hospital from March 2016 to September 2017 were divided into two groups according to NYHA cardiac function grade Ⅱ (n=72), cardiac function grade Ⅲ (n=75) and cardiac function grade Ⅳ (n=56). Meanwhile, 50 healthy volunteers in the same period were selected as the control group. BUA, Hcy, NT-proBNP and LVEF were compared in each group. One year follow-up, according to the prognosis, patients were divided into poor prognosis group and good prognosis group. ROC curve was used to analyze the prognostic value of BUA and Hcy. 【Results】The levels of BUA, Hcy and NT-proBNP in the observation group were significantly higher than those in the control group, the difference was statistically significant (P<0.05);compared with levf, the difference was not statistically significant (P>0.05). The levels of BUA, Hcy and NT-proBNP were the highest in grade Ⅳ group, the second in grade Ⅲ group, and the lowest in grade Ⅱ Group (P<0.05). Pearson analysis showed that serum BUA and Hcy levels were positively correlated with NT-proBNP (r=0.784 and 0.732, respectively, P<0.05). 203 patients were hospitalized or died due to adverse mace events (poor prognosis group), including 27 cases of central colic, 19 cases of acute myocardial infarction, 13 cases of serious arrhythmia and 5 cases of death. The other 139 patients were included in the good prognosis group. The proportion of NYHA Ⅲ~Ⅳ, serum BUA, Hcy and NT-proBNP water in patients with good prognosis were lower than those in patients with poor prognosis (P<0.05).【Conclusion】The level of serum BUA and Hcy in HFPEF patients increases significantly, which is positively correlated with left ventricular function, and has a certain reference value

关 键 词：心力衰竭 心排血量 心室 尿酸/血液 半胱氨酸/血液 

分 类 号：R541.61[医药卫生—心血管疾病]