尿酸在成人先天性心脏病合并肺动脉高压的影响

Effects of uric acid in adults with congenital heart disease complicating with pulmonary hypertension

目的:观察尿酸在成人先天性心脏病合并肺动脉高压患者的改变及其两者间的关系。方法:纳入2007年5月至2009年4月在本科室就诊的26例成人先天性心脏病患者,分为肺动脉高压组(PH组)和无肺动脉高压组(无PH组)各13例两组均抽取血标本检测血尿酸、CRP水平,同时测定肺呼气功能,评价患者6min步行距离。结果:在入选的成人先天性心脏病患者中,与无肺动脉高压组比较,合并肺动脉高压组患者6 min步行距离明显下降,[(423±98)m vs(383±113)m,P<0.05],而血尿酸水平明显升高,(280±78)mmol/L vs(320±82)mmol/L,P<0.05)]在合并肺动脉高压组患者,6 min步行距离与血尿酸水平呈明显负相关关系(r=-0.633,P=0.036)结论:高血尿酸与先心合并肺动脉高压的程度及预后密切相关,临床对先心病患者早期的尿酸检测,对早期判断先心病合并肺动脉高压可能具有重要的临床意义。

Objective： To determine the alteration in serum uric acid （UA） and the correlation with pulmonary pressure in adults as having congenital heart disease complicating with pulmonary hypertension. Methods： Twenty-six consecutive adults with congenital heart disease were enrolled from the department of cardiology, Affiliated Hospital of Guilin Medical College between May 2007 and April 2009 and were allocated into pulmonary hypertension （ group PH, n = 13 ） and non-pulmonary hypertension group （ group non-PH, n = 13） ,respectively. Blood specimens were sampled for measurement of UA and C-reactive protein. Lung function, including spirometry and 6-minute-walk distance, was also assessed. Results ： Group PH yielded remarkably lower 6-minute-walk distance[ （423 ± 98） m vs（383 ± ll3） m,P 〈 0.05 ] than group non-PH. Significant increase in the level of UA was noted in group PH,but not group non-PHI （280 ±78） mmol/L vs. （320 ±82） mmol/L, P 〈 0.05 ]. Blood UA was negatively correlated with 6-minute-walk distance （ r = - 0. 633,P = 0. 036） in group PH. Conclusion：Elevated serum UA is closely related to grading of PH and prognosis in adults with congenital heart disease. Early detection of UA might be clinically helpful to the diagnosis of pulmonary hypertension in adults with congenital heart disease.