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心力衰竭患者血尿酸与有创血液动力学监测指标、血浆N末端B型利钠肽原和高敏C反应蛋白的相关研究 被引量:14

Association of serum uric acid, plasma NT-proBNP, Hs-C reactive protein and invasive hemodynamic parameters in patients with heart failure
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摘要 目的评价心力衰竭(心衰)患者血尿酸与有创血液动力学监测指标、血浆N末端B型利钠肽原(NT-proBNP)和高敏c反应蛋白(Hs-CRP)的相关性。方法选择141例NYHAⅡ-Ⅳ级心衰患者,在入院12h内行漂浮导管监测和血尿酸等常规检查,同时检测血浆NT-proBNP和Hs-CRP。结果高尿酸血症的比率为55.30%,肺毛细血管楔压(PCWP)在高尿酸血症总组及高尿酸血症A、B、C组均较正常血尿酸组显著增高(P〈0.01,P=0.01,P〈0.01,P〈0.01)。血浆NT-proBNP在高尿酸血症总组和高尿酸血症c组较正常血尿酸组显著增高(P=0.02,P〈0.01)。与PCWP〈18mmHg(1mm Hg=0.133kPa)组比较,高NT-proBNP和高尿酸血症比率在PCWP≥18mmHg、〈28mmHg组和PCWP/〉28mmHg组均显著增高(P=0.01,P=0.02;P〈0.01,P〈0.01)。偏相关分析表明,血尿酸分别与右房压、右室压、肺动脉压和PCWP相关(r=0.19,P=0.03;r=0.45,P〈0.01;r=0.23,P=0.01;r=0.24,P=0.01)。多元回归分析表明,血尿酸和血浆NT—proBNP分别与PCWP独立相关(B=0.24,P=0.01;13=0.47,P〈0.01)。血浆Hs-CRP以及左室射血分数与血尿酸及PCWP均不相关。结论心衰患者血尿酸水平与PCWP等有创血液动力学指标独立相关,与血浆NT.proBNP结合可能更有利于心衰患者的临床评价。 Objective To explore the correlation of serum uric acid, invasive hemodynamic parameters, plasma N-terminal proBNP (NT-proBNP) and Hs-C reactive protein (Hs-CRP)in patients with heart failure. Method Invasive hemodynamie parameters derived from Swan-Ganz catheter, serum uric acid, plasma NT-proBNP and Hs-CRP within 12 hours after hospital admission were analyzed in 141 patients with chronic heart failure [New York Heart Association (NYHA) classⅡ-Ⅳ]. Results Incidence of hyperuricemia was 55.30% in this patient cohort. Pulmonary capillary wedge pressure(PCWP) and plasma NT-proBNP in hyperuricemia patients were significantly higher than those in non-hyperuricemia patients ( P 〈 0. 01 ). The percentages of high plasma NT-proBNP ( 〉 600 pmol/L) and hyperuricemia were significantly higher in patients with PCWP≥18 and 〈 28 mm Hg (1 mm Hg = 0.133 kPa) and patients with PCWP≥28mm Hg compared those in patients with PCWP 〈 18 mm Hg, ( P = 0. 01, P = 0. 02 ; P 〈 0. 01, P 〈 0. 01, respectively). Partial correlation analysis showed that serum uric acid correlated with fight atrial pressure, fight ventricular pressure, pulmonary arterial pressure and PCWP (r = 0. 19,P = 0. 03 ; r = 0. 45,P 〈 0. 01 ; r = 0. 23, P = 0. 01 ; r = 0. 24, P = 0. 01, respectively). Multiple linear regression analysis showed both serum uric acid and plasma NT-proBNP correlated independently with PCWP ( 13 = 0. 24, P = 0. 01 ; β= 0.47, P 〈 0. 01, respectively) while plasma Hs-CRP and left ventricular ejection fraction were not correlated with serum uric acid and PCWP ( P 〉 0. 05 ). Conclusion Serum uric acid independently correlated with PCWP in patients with heart failure and the combined measurements of serum uric acid and plasma NT-proBNP are helpful in evaluating the prognosis of patients with heart failure.
出处 《中华心血管病杂志》 CAS CSCD 北大核心 2009年第2期126-129,共4页 Chinese Journal of Cardiology
基金 北京市科委科技计划资助课题(2006BKJ3)
关键词 心力衰竭 充血性 尿酸 利钠肽 Heart failure,congestive Uric acid Natriuretic peptide,brain
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参考文献9

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二级参考文献15

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