老年慢性心衰患者高敏C反应蛋白和血尿酸变化的意义

Significance of concentration change of serum uric acid and high sensitive C-reactive protein in aged patients with chronic heart failure

目的:探讨老年慢性心力衰竭(CHF)患者高敏C反应蛋白(hs-CRP)、血尿酸(UA)的浓度变化及意义。方法:选择67例NYHAⅡ一Ⅳ级老年CHF患者(心衰组)及29例正常老年人(正常对照组),测定血清UA、hs-CRP的水平,超声心动图测量左心室射血分数(LVEF)。结果:心衰组患者血清hs-CPR[(8.78±4.35)mg/L∶(1.27±0.48)mg/L]、UA[(451±83)μmol/L∶(289±25)μmol/]均较正常对照组明显增高(P均<0.01)。且随着NYHY心功能级别增高,血UA水平逐渐升高,其组间差异性显著(P<0.01),二者呈正相关(r=0.39;P<0.01)。血清hs-CPR随NYHA分级的增加而升高,但组间无显著性差异(r=0.187,P=0.079)。血UA水平与血清hs-CRP无显著相关(r=0.389,P=0.065)。结论:老年慢性心力衰竭患者血尿酸水平与心衰分级有很好的相关性,它结合NYHA分级方法及左室射血分数能更好地反映心衰患者的严重程度。

Objective： To study the significance of concentration change of serum uric acid and high sensitive C- reactive protein （hs-CRP） in aged patients with chronic heart failure. Methods： The level of serum uric acid （UA） and hs-CRP were detected and left ventricular ejection fraction was estimated by echocardiography in 67 aged patients with congestive heart failure （CHF, NYHA Ⅱ-Ⅳ class, CHF group） and 29 normal persons （normal control group）.Results：. The hs-CPR [ （8.78＋4. 35） mg/L vs. （ 1.27＋0. 48） mg/L], UA [ （451＋83） pmol/L vs. （289＋25） μmol/L] in CHF group significantly increased compared with those of normal control group （P〈0. 01）. The serum UA level gradually increased follow NYHA class increased, its interclass difference was significant （P〈0. 01）, and there was positive correlation between UA level and NYHA class （r=0.39; P〈0.01）. The serum hs-CRP level also gradually increased follow NYHA class increased, but its interclass difference was no significant （P〉0.05）, and there was no correlation between hs-CRP level and NYHA class （r=0. 389, P=0. 065）. Conclusion： There is positive correlation between UA level and NYHA class in aged patients with chronic heart failure, UA level combined NYHA class and LVEF would better reflect CHF severity.