血清尿酸与哮喘急性发作严重程度及肺功能的相关性

Correlation of serum uric acid with severity of acute asthma attack and pulmonary function in asthmatic patients

目的探讨哮喘急性发作患者血清尿酸水平与病情严重程度及肺功能的关系。方法哮喘急性发作患者126例(观察组),其中轻度和中度患者88例为非危重组,重度和危重度患者38例为危重组,于入院时检测血清尿酸水平,行肺功能检查记录用力肺活量(forced vital capacity,FVC)占预计值百分比(FVC%pred)、第1秒用力呼气容积占预计值百分比(percentage of forced expiratory volume in one second of the predicted value,FEV1%pred)、呼气峰流量占预计值百分比(percentage of peak expiratory flow of the predicted values,PEF%pred),并与126例同期体检健康者(对照组)进行比较;采用Pearson相关分析哮喘急性发作患者血清尿酸水平与肺功能的相关性;绘制ROC曲线评价血清尿酸对哮喘急性发作重度和危重度的诊断价值。结果观察组血清尿酸水平[(353.96±61.27)μmol/L]高于对照组[(275.63±53.86)μmol/L],FVC%pred[(72.5±17.6)%]、FEV1%pred[(69.5±16.9)%]、PEF%pred[(72.1±19.8)%]低于对照组[(86.3±9.1)%、(89.1±8.3)%、(85.9±7.6)%](P<0.05);危重组血清尿酸水平[(395.08±73.49)μmol/L]高于非危重组[(335.59±58.73)μmol/L],FVC%pred[(54.5±12.0)%]、FEV1%pred[(45.4±12.7)%]、PEF%pred[(60.3±20.2)%]低于非危重组[(81.3±15.3)%、(79.8±17.5)%、(84.4±18.3)%](P<0.05);哮喘急性发作患者血清尿酸水平与病情严重程度呈正相关(r=0.63,P=0.002),与FVC%pred(r=-0.49,P=0.012)、FEV1%pred(r=-0.41,P=0.029)和PEF%pred(r=-0.58,P=0.036)均呈负相关;血清尿酸以379.5μmol/L为最佳截断值,诊断哮喘急性发作重度和危重度的AUC为0.829(95%CI:0.743～0.916,P<0.001),灵敏度为73.7%,特异度为85.2%。结论哮喘急性发作患者血清尿酸水平与病情严重程度、肺功能密切相关,可作为评价哮喘急性发作及严重程度的生物标志物。

Objective To explore the relationship of serum uric acid(UA)level with the severity of acute asthma attack and pulmonary function in asthmatic patients.Methods Totally 126 patients with acute asthma attack(observation group)were divided into 88 patients with mild and moderate asthma(non-critical group)and 38 patients with severe and critical asthma(critical group).The serum level of UA was detected at admission,percentage of forced vital capacity of the predicted value(FVC%pred),percentage of forced expiratory volume in one second of the predicted value(FEV1%pred)and percentage of peak expiratory flow of the predicted values(PEF%pred)were recorded,and were compared with another 126 healthy volunteers(control group).The correlation of UA with the pulmonary function was analyzed by Pearson correlation.ROC was drawn to evaluate the value of serum UA to the diagnosis of acute attack of severe and critical asthma.Results The serum UA level((353.96±61.27)μmol/L)was significantly higher,while FVC%pred((72.5±17.6)%),FEV1%pred((69.5±16.9)%)and PEF%pred((72.1±19.8)%)were significantly lower in observation group than those in control group((275.63±53.86)μmol/L,(86.3±9.1)%,(89.1±8.3)%,(85.9±7.6)%)(P<0.05).The serum level of UA((395.08±73.49)μmol/L)was significantly higher,while FVC%pred((54.5±12.0)%),FEV1%pred((45.4±12.7)%)and PEF%pred((60.3±20.2)%)were significantly lower in critical group than those in non-critical group((335.59±58.73)μmol/L,(81.3±15.3)%,(79.8±17.5)%,(84.4±18.3)%)(P<0.05).The serum UA was positively correlated with the severity of asthma(r=0.63,P=0.002),and was negatively correlated with FVC%pred(r=-0.49,P=0.012),FEV1%pred(r=-0.41,P=0.029)and PEF%pred(r=-0.58,P=0.036).When the optimal cut-off value of UA was 379.5μmol/L,the AUCfor the diagnosis of acute attack of severe and critical asthma was 0.829(95%CI:0.743-0.916,P<0.001),the sensitivity was73.7% and the specificity was 85.2%.Conclusion Serum UA is closely correlated with the severity of acute asthma attack and pulmonary function,and it could be used as a biomarker for the severity of acute asthma attack.