血清尿酸水平评估慢性阻塞性肺疾病急性加重者病情的临床价值

Serum uric acid level as a potential indicator for acute exacerbation of chronic obstructive pulmonary disease

目的探讨血清尿酸水平评估慢性阻塞性肺疾病急性加重(AECOPD)者病情的临床价值。方法收集2014年4月至2015年4月在呼吸科住院治疗的1 1 1例经肺功能检测确诊的AECOPD患者的临床资料。以血清尿酸值416μg/L为临界点,分成血清尿酸>416μg/L组,血清尿酸<416μg/L组,进行临床资料分析。结果血清尿酸>416μg/L组以男性为主,年龄更大,吸烟率更高,肺功能更差,D级患者构成比更多,在首次住院床日、1年内机械通气发生率、1年内病死率、1年内住院次数均显著高于血清尿酸<416μg/L组(P<0.05或0.01)。血清尿酸>416μg/L组呼吸衰竭更严重,更多合并有冠心病、充血性心力衰竭、心律失常、糖尿病、恶性肿瘤、意外骨折和褥疮(P<0.05或0.01)。结论测定AECOPD患者血清尿酸水平有助于对其病情及预后作出评估。

Objective To assess the value of serum uric acid in predicting acute exacerbation of chronic obstructive pulmonary disease （AECOPD）. Methods A total of 111 cases of AECOPD admitted in our hospital during April 2014 to April 2015 were included. Lung function was tested and serum uric acid levels were measured. There were X cases with high uric acid levels （〈416μg/L, group A） and X cases with low uric acid levels（〈416μg/L, group B）. Results There were significantly differences in mechanical ventilation rate （noninvasive and invasive mechanical ventilation）, mortality rate in 1 year, hospitalization rate in 1 year, the length of first hospitalization in 1 year （P〈0.01） between two groups. There were more male patients, more D stages, higher ages, higher smoking rates, worse lung function, more coronary artery disease, more congestive heart failure, more arrhythmias, more diabetes, more cancer, more unexpected fractures and more bedsore in group A than in group B （P〈0.05 or P〈0.01）. Conclusion Serum uric acid can be used as an indicator for acute exacerbation in COPD patients.