慢性心力衰竭与高尿酸血症关系探讨

目的探讨慢性心力衰竭（chronic heart failure,CHF）患者心功能和血尿酸（uric acid,UA）水平及左室重构程度的关系。方法 236例CHF患者,按NYHA心功能分级分为Ⅱ、Ⅲ、Ⅳ级,分为3组,分别为78、86、72例;按UA水平分为正常血尿酸组（132例）和高尿酸血症组（104例）。所有入选者入院后急诊或常规检查尿酸、肝肾功能、电解质等项目;超声心动图测定心脏左室舒张末期内径（left ventricular end diastolic diameter,LVEDd）、左室后壁厚度（left ventricular posterior wall diameter,LVPWd）,计算左室射血分数（left ventricular ejection fraction,LVEF）。结果心力衰竭患者血尿酸明显升高,发生率为44.1%,随着心功能损害的加重,高尿酸血症的发生率增加（χ2=8.46,P〈0.05）,尿酸水平增高（F=11.68,P〈0.05）;血尿酸增高者左室舒张末内径明显增大,左室射血分数显著降低,（P〈0.05）,相关分析显示LVEDd与血尿酸水平正相关（r=0.386,P〈0.01）,LVEF与血尿酸水平负相关（r=-0.324,P〈0.05）。（F=11.68,P〈0.05）。结论随着心力衰竭程度的加重,尿酸水平逐步升高。

Serum uric acid level in patients with chronic heart failure

Objective To evaluate the association of the serum uric acid(UA) level with cardiar function in chronic heart failure(CHF)patients.Methods A total of 236 CHF patients were divided into three groups according to the New York Heart Association(NYHA) criteria.The number of NYHA II-IV was 78,86,72 respectively.According to levels of serum UA,the patients were divided into two groups: normal UA group(132) and hyperuricemia group(104).All the patients underwent the routine test during the emergency disposal or the next morning after admission.They received echocardiography one week after admission.LVEDd,LVPWd,and LVEF were measured.Result CHF patients had a high level of UA.The incidence of hyperuricemia was 44.1%,correlated with the NYHA grades(χ2=8.46,P<0.05).The level of serum UA was also correlated with the NYHA grades(F=11.68,P<0.05).The level of LVEDd was higher in patients of hyperuricemia than in normal UA.Simple linear correlation confirmed that LVEDd(r=0.386,P<0.01) and LVEF(r=-0.324,P<0.05) are correlated with UA.Conclusion Serum UA is correlated with the NYHA grades in CHF patients.