尿酸水平与先天性心脏病相关性肺动脉高压相关性研究

Relationship of uric acid level and congenital heart disease associated with pulmonary hypertension

目的探讨尿酸水平与先天性心脏病相关性肺动脉高压患者病情严重程度的相关性。方法回顾性分析自2009年1月至2016年12月海军军医大学附属长海医院收治的279例先天性心脏病相关性肺动脉高压患者的临床资料,根据患者预后,分为存活组257例和病死组22例,比较两组患者基线资料,并采用Spearman秩相关进行相关性分析。结果病死组患者肺动脉收缩压、肺动脉舒张压、肺动脉平均压、尿酸、红细胞分布宽度分别为(103.60±29.67)mmHg、(49.60±18.08)mmHg、(68.36±21.73)mmHg、(0.42±0.11)mmol/L、18.00%(13.93%,75.47%),均高于存活组的(85.21±30.28)mmHg、(37.85±18.90)mmHg、(55.01±21.42)mmHg、(0.26±0.17)mmol/L、13.80%(12.80%,21.60%),差异有统计学意义(P<0.05);尿酸水平与肺动脉收缩压、肺动脉舒张压、肺动脉平均压呈正相关(P<0.01)。结论尿酸水平与肺动脉压力呈正相关,可在一定程度上反映先天性心脏病相关性肺动脉高压患者的病情严重程度。

Objective To investigate the relationship of uric acid in the assessment of congenital heart disease associated pulmonary hypertension. Methods A retrospective study was performed on 279 cases of patients with congenital heart disease associated pulmonary hypertension（ CHD-PH） from January 2009 to December 2016. According to the prognosis,patients were divided into the survival group（ n = 257） and the death group（ n = 22）. The baseline data was compared between the two groups,Spearman rank correlation was used for correlation analysis. Results The pulmonary artery systolic pressure,pulmonary artery diastolic pressure,mean pulmonary arterial pressure,uric acid and the distribution of red blood cells in the death group were significantly higher than those in the survival group：（ 103. 60 ± 29. 67） mmHg versus（ 85. 21 ± 30. 28） mmHg,（ 49. 60 ± 18. 08） mmHg versus（ 37. 85 ± 18. 90） mmHg,（ 68. 36 ±21. 73） mmHg versus（ 55. 01 ± 21. 42） mmHg,（ 0. 42 ± 0. 11） mmol/L versus（ 0. 26 ± 0. 17） mmol/L,18. 00%（ 13. 93%,75. 47%） versus 13. 80%（ 12. 80%,21. 60%）（ P〈0. 05）. Uric acid was positively correlated with pulmonary arterial systolic pressure,pulmonary arterial diastolic pressure and pulmonary arterial mean pressure（ P〈0. 01）. Conclusion Uric acid is positively related to pulmonary arterial pressure,which can reflect the severity of the disease in patients with congenital heart disease associated with pulmonary hypertension.