慢性心力衰竭患者血清尿酸水平和左心房室收缩功能的关系

The Relationship between Serum Uric Acid and of Left Atria and Ventricle in Patients with Chronic Heart Failure

目的:探讨慢性心力衰竭(CHF)患者血清尿酸水平与左心房室收缩功能的关系。方法:入选72例不伴心房颤动的CHF患者,同时选择56例健康体检者做为对照。生化技术测定两组样本的血清尿酸水平。多普勒超声测量两组样本的左心房前后径。左心室舒张末期内径,左心室射血分数,心房收缩期二尖瓣前向血流峰速和肺静脉逆向血流峰速并对血清尿酸水平与心脏超声结果参数进行相关性分析。结果:病例组的血清尿酸水平、左心房前后径和左心室舒张末期内径显著大于对照组(p<0.001)左心室射血分数、心房收缩期二尖瓣前向血流和肺静脉逆向血流显著低于对照组(p<0.001)。病例组血清尿酸水平与左心室舒张末期内径正相关(r=264,P=0.026),与左心室射血分数强负相关(r=-0.639,p<0.001),但与左心房前后径、心房收缩期二尖瓣前向血流和肺静脉逆向血流无相关关系(p>0.05)。结论:尿酸可能通过介导心室重构、加速动脉粥样硬化直接影响到CHF患者的左心室收缩功能。心房收缩功能的变化继发于心室重构后出现。

Objective：The study was designed to analyze the relationship between the level of serum uric acid（UA） and the systolic function of left atria and ventricle in patients with chronic heart failure（CHF）.Methods：72 patients with CHF without atrial fibrillation were enrolled,another 56 healthy subjects served as controls.The serum UA level was assayed by biochemical method,and the changes of left atrial diameter（LAD）,left ventricular end-diastolic dimension（LVEDD）,Left ventricular ejection fraction（LVEF）,the peak A-wave velocity（Ap） and the peak Z-wave velocity （Zp） in atrial systolic phase were determined using Doppler echocardiography.Results：The level of serum UA and the size of LAD and LEVDD in patients were significantly higher and greater than that in controls（P〈0.001）,while the value of LVEF,Ap and Zp in patients were lower than that in controls（P〈0.001）.In patients,there was a positive correlation between the serum UA level and the value of LVEDD（r=0.264,P=-0.026）,and a strong negative correlation between the serum UA level and the value of LVEF（（r=-0.639,P〈0.001）,bnt there were no correlations between the serum UA level and the size of LAD,the value of Ap and Zp（P〉0.05）.Conelnsioa： UA may directly influence the left ventricular systolic function in patients with CHF through mediating ventricular remodeling and promoting atheroselerosis.The decrease of/eft atrial systolic function may be probably secondary to ventricular remodeling.