慢性心力衰竭患者心功能与血尿酸、超敏C反应蛋白和血胆红素的相关性研究

Association of serum uric acid, high-sensitivity C-reaction protein and serum bilirubin with cardiac function in patients with chronic heart failure

目的探讨慢性心力衰竭（CHF）患者心功能与血尿酸（UA）、超敏C反应蛋白（hs-CRP）和血清胆红素的相关性。方法选择96例慢性心力衰竭患者为CHF组，按纽约心脏病协会（NYHA）心功能分级分为3组：心功能Ⅱ级38例，心功能Ⅲ级40例，心功能Ⅳ级18例。另外选取在本院体检的心功能正常者62名作为对照组。所有人选者于人院第2天采空腹静脉血测定UA、hs—CRP和血清胆红素水平。结果CHF组UA、hs-CRP和血胆红素水平明显高于对照组，差异有统计学意义（P〈0．01或P〈O．05）。不同心功能分级患者间比较UA、hs-CRP和血胆红素水平差异均有统计学意义；NYHAIV级患者UA、hs-CRP和血胆红素水平明显高于其他两组，其中UA和血胆红素水平比较差异有统计学意义（P〈0．01），而hs-CRP比较差异无统计学意义（P〉O．05）。结论血UA、hs-CRP和胆红素水平升高在CHF发生、发展中起一定作用，检测慢性心衰患者UA、hs-CRP和血清胆红素水平有助于判断心衰严重程度并指导临床治疗。

Objective To investigate association of cardiac function in patients with the chronic heartfailure （CHF） and serum uric acid （UA）, high sensitive C-reactive protein （hs-CRP） and serum bilirubin. Methods Choose 96 patients with chronic heart failure with CHF group, according to New York Heart Association （NYHA） functional class were divided into three groups： 38 eases of grade Ⅱ heart function, 40 cases of grade Ⅲ, grade IV heart function in 18 patients. Meanwhile selected 62 cases with normal heart function of physical examination in our hospital as the control group. All patients in the hospital have measured UA, serum bilirubin and hs-CRP levels on second day by collected fasting venous blood. Results CHF group UA, hs-CRP and serum bilirubin levels were obviously higher than control group, in which there was significant statistical significance （P〈0.01）, hs-CRP was also statistically significant （P〈0.05）. In CHF group among different cardiac function, UA, hs-CRP and serum bilirubin levels were significantly different, in patients with NYHA IV, UA, hsCRP and serum bilirubin levels were obviously higher than the other two groups, which UA and blood bilirubin level were statistically significant （P〈0.001）, while hs-CRP was no difference （P〉0.05）. Conclusion Blood UA, hs-CRP and bilirubin levels may play important roles in the development of CHF, the detection of serum uric acid, hs-CRP and serum bilirubin levels in patients with chronic heart failure can help to determine the severity of heart failure and guide clinical treatment.