摘要
目的 探讨高血压性急性心力衰竭患者治疗前的血清尿酸(SUA)水平与治疗后疾病严重程度及5年病死率的相关性。方法 选取了河北省沧州市黄骅市人民医院2019年9月—2022年9月收治的122例高血压性急性心力衰竭患者,根据入院时的SUA水平将其分为高尿酸血症组(男性SUA≥420μmol/L,女性SUA≥360μmol/L)和正常尿酸组,比较两组患者的基线特征、临床表现和5年随访结果。采用多变量Cox回归模型评估SUA水平对5年病死率的影响,并使用Kaplan-Meier生存曲线进行生存分析。比较两组左心室功能和心血管不良事件(MACE)。结果 高尿酸血症组患者的BMI、白细胞、白蛋白、肌酐、尿素氮、胆固醇、低密度脂蛋白胆固醇SUA水平显著高于正常尿酸组,血小板和肾小球滤过率显著低于正常尿酸组(P<0.05)。在冠状动脉狭窄情况,高尿酸血症组涉及的血管支数和Gensini积分均显著高于正常尿酸组(P<0.05),且血清尿酸水平与Gensini积分呈强正相关(r=0.778,P<0.05)。随访结果显示,高尿酸血症组的5年病死率显著升高,且尿酸是5年病死率的独立危险因素(HR=1.017,95%CI=1.011~1.024,P<0.001)。出院前的心脏超声检查结果显示,两组间的LVESV和LVEDV比较差异有统计学意义(P<0.05),但LVEF组间差异无统计学意义(P>0.05)。此外,尽管高尿酸血症组的MACE发生率偏高,但两组间差异并无统计学意义(P>0.05)。结论 在高血压性急性心力衰竭患者群体中,治疗前SUA水平与疾病严重程度以及5年病死率增加相关。治疗前高水平SUA可预测高血压性急性心力衰竭患者的不良结局。
Objective The aim of this study was to investigate the correlation between pre-treatment serum uric acid(SUA) levels in patients with hypertensive acute heart failure and post-treatment disease severity and 5-year mortality.Methods One hundred and twenty-two patients with hypertensive acute heart failure were selected and divided into a hyperuricemia group(SUA ≥420 μmol/L in men and SUA ≥360 μmol/L in women) and a normaturic group according to their SUA levels on admission,and the baseline characteristics,clinical manifestations,and 5-year follow-up results were compared between the two groups.Multivariate Cox regression models were used to assess the effect of SUA levels on 5-year mortality,and survival analyses were performed using Kaplan-Meier survival curves.Results The levels of BMI,white blood cell,albumin,liver anhydride,urea nitrogen,cholesterol,low density lipoprotein cholesterol and SUA in hyperuricemia group were significantly higher than those in hyperuricemia group(P<0.05).In terms of coronary artery stenosis,the number of vessel branches involved and Gensini score were significantly higher in the hyperuricaemia group than in the normal group(P<0.05),and the serum uric acid level showed a strong positive correlation with the Gensini score(r=0.778,P<0.05).Follow-up results showed that the 5-year mortality rate was significantly higher in the hyperuricaemia group and that uric acid was an independent risk factor for 5-year mortality(HR=1.017,95%CI=1.011-1.024,P<0.001).Pre-discharge cardiac ultrasound showed a statistically significant difference in LVESV and LVEDV between the two groups(P< 0.05),but not in LVEF(P>0.05).In addition,although the incidence of MACE was high in the hyperuricaemia group,the difference between the two groups was not statistically significant(P>0.05).Conclusion Pre-treatment SUA levels were associated with increased disease severity as well as 5-year mortality in a population of patients with hypertensive acute heart failure.High pretreatment levels of SUA increased adve
作者
赵俊凤
张楠
孟永
ZHAO Junfeng;ZHANG Nan;MENG Yong(Department of Cardiology,People′s Hospital of Huanghua City,Cangzhou Hebei 061100,China)
出处
《中国急救复苏与灾害医学杂志》
2024年第7期841-844,854,共5页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
国家自然科学基金地区科学基金项目(编号:81860162)
云南省科技厅-昆明医科大学应用基础联合专项基金(编号:2013FB140)。
关键词
高血压性急性心力衰竭
尿酸
预后
Hypertensive acute heart failure
Uric acid
Coronary artery disease
Prognosis
