老年心力衰竭患者血清尿酸水平变化的临床分析

Significance of level of serum uric acid in aged patients with chronic heart failure

目的:探讨不同病因心力衰竭患者的血清尿酸水平及心功能改善后血清尿酸水平的变化。方法:78例老年心力衰竭患者根据病因分为冠心病组、高血压性心脏病组、扩张型心肌病组及风湿性心脏病组。分别测量各组患者血清尿酸含量。并按心功能分级分为Ⅱ级组、Ⅲ级组、Ⅳ级组,给予强心、利尿、扩血管等治疗8周。治疗前、后分别测量血尿酸含量。结果:不同病因所致心衰患者血清尿酸水平均升高(P<0.01),且冠心病、高血压心脏病心衰患者升高显著(P<0.001)。按心功能分级三组间组组比较血清尿酸水平差异显著(P<0.01)。心衰纠正后尿酸水平显著降低较治疗前有明显差异(P<0.01)。结论:老年心衰患者血清尿酸水平增高且随心衰加重而升高明显。血清尿酸水平为测定患者心衰严重程度及评定疗效提供一项有价值的指标。

Objective： To explore the significance of level of serum uric acid in aged patients with chronic heart failure （CHF） of different etiologies and its change after cardiac function ameliorated. Methods.. Level of serum uric acid was determined in 78 aged patients with congestive heart failure （CHF） before and after treatment. Results： All CHF patients had higher uric acid levels compared with control group （P〈0. 01） . Patients with ischemic or hypertensive etiologies had higher uric acid level than patients with dilated cardiomyopathy and rheumatic heart disease （P〈0. 001）. The level of serum uric acid of NYHA cardiac function class Ⅳ group was significantly higher than that of class Ⅲ group and of class Ⅲ group was higher than that of Ⅱ group （P〈0.01）. After treatment the level of uric acid significantly decreased （P〈0.01）. Conclusion： Level of serum uric acid is a good index for evaluating prognosis and therapeutic efficacy in patients with CHF.