老年心力衰竭患者血清尿酸水平与不良预后的相关性分析  

Correlation between serum uric acid and adverse prognosis in elderly patients with heart failure

作　　者：王文友 周平 郑娟娟 吕慈 章陈晨 王童 王伟 刘凌燕 Wang Wenyou;Zhou Ping;Zheng Juanjuan;LYU Ci;Zhang Chenchen;Wang Tong;Wang Wei;Liu Lingyan(Department of Geriatrics and Special Service Medicine,Southwest Hospital,Army Medical University,Chongqing,400038,China)

机构地区：[1]陆军军医大学第一附属医院老年医学与特勤医学科,重庆400038 [2]陆军军医大学(第三军医大学)军事预防医学系毒理学研究所,电磁辐射医学防护教育部重点实验室

出　　处：《中华老年心脑血管病杂志》2024年第12期1414-1418,共5页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的评估老年心力衰竭(heart failure,HF)患者血清尿酸水平对不良预后的影响。方法回顾性研究2016年12月至2019年6月四川省自贡市第四人民医院因HF诊断入院的患者1583例,根据基线血清尿酸水平分为低尿酸组(≤386.8μmol/L)523例,中尿酸组(386.9~523.6μmol/L)537例,高尿酸组(>523.6μmol/L)523例。采用多因素logistic回归模型分析相关性。结果高血清尿酸组6个月不良结局事件发生率明显高于低尿酸组(P<0.05)。与低尿酸组比较,高尿酸组6个月再入院风险显著增加(RR=1.531,95%CI:1.180~1.988,P=0.001),高尿酸组6个月复合不良事件风险也显著增加(RR=1.624,95%CI:1.255~2.102,P=0.000)。纽约心脏病协会心功能Ⅳ级、糖尿病是老年HF患者6个月复合不良事件的独立影响因素(P<0.05,P<0.01)。血清尿酸水平与老年HF患者不良预后的剂量-反应关系整体呈线性趋势,表现为随血清尿酸水平升高,6个月死亡、再入院及复合不良事件风险均升高。结论老年HF患者血清尿酸水平升高与不良预后存在显著相关。Objective To investigate the effect of SUA level on adverse prognosis in elderly patients with HF.Methods A retrospective analysis was conducted on 1583 patients admitted to Zigong Fourth People's Hospital between December 2016 and June 2019 due to a diagnosis of HF.The patients were divided into low SUA group(≤386.8μmol/L,523 cases),medium SUA group(386.9-523.6μmol/L,537 cases),and high SUA group(>523.6μmol/L,523 cases).Multivariate logistic regression model was employed to assess the relationship between SUA level and adverse outcomes in the elderly HF patients.Results The incidence of adverse events was significantly higher in the high SUA group than that in the low SUA group in 6 months of follow-up(P<0.05).When compared with the low SUA group,the high SUA group had a significantly increased risk of readmission within 6 months(RR=1.531,95%CI:1.180-1.988,P=0.001),and elevated risk of compound events(RR=1.624,95%CI:1.255-2.102,P=0.000).NYHA gradeⅣand diabetes were independent influencing factors for 6-month adverse prognosis in elderly patients HF(P<0.05,P<0.01).An approximately linear trend was observed in the dose-response relationship of SUA level and adverse prognosis,indicating an increased risk of short-term death,readmission,and compound events as increment of SUA level.Conclusion Higher SUA level is significantly associated with adverse prognosis in elderly HF patients.

关 键 词：心力衰竭 尿酸 预后 数据相关性 

分 类 号：R541.6[医药卫生—心血管疾病]