云南省慢性心力衰竭患者并发高尿酸血症的流行病学调查

Prevalence of hyperuricemia in patients with chronic failure in Yunnan Province

目的调查云南省慢性心力衰竭(chronic h heart failure,CHF)患者高尿酸血症(hyperuricemia,HUA)的发病率,为云南地区CHF患者的防治提供科学依据。方法回顾性研究2009年1月至2015年12月大理大学第一附属医院、曲靖市第一人民医院2 483例CHF患者的不同心功能级别、射血分数保持的心力衰竭(heartfailure with preserved ejection fraction,HFpEF)和射血分数降低的心力衰竭(heart failure with reduced ejectionfraction,HFrEF)、性别、年龄、病因的HUA发病率。结果 CHF患者的HUA发病率为53.84%,男性52.95%,女性54.86%,男女发病率比较,差异无统计学意义(P<0.05)。青年组HUA的发病率(男性61.87%,女性58.27%)高于其他年龄组,差异有统计学意义(P<0.05)。CHF患者中心功能Ⅱ级、Ⅲ级、Ⅳ级的HUA发病率分别为37.48%、53.99%、65.54%,心功能越差,HUA发病率越高。HFrEF患者HUA发病率明显高于HFpEF患者,差异有统计学意义(65.76%vs. 46.48%,P<0.05)。不同疾病所致CHF的HUA发病率各不相同,差异有统计学意义(P<0.05),以扩张型心肌病的HUA发病率最高,为65.02%。结论云南省CHF患者的HUA发病率较高,HUA可能是预测CHF的独立危险因素之一。

Objectives To explore the prevalence of hyperuricemia(HUA)in patients with chronic heart failure(CHF)in Yunnan Province.Methods The clinical data of2483patients with CHF from January2009to December2015in the First Affiliated Hospital of Dali University and Qujing City People′s Hospital were collected.According to age,cardiac function of New York Heart Association(NYHA)class,heart failure with preserved ejection fraction(HFpEF)and heart failure with reduced ejection fraction(HFrEF),sex,age,etiology,the prevalence of HUA in patients with CHF was investigated.Results HUA prevalence was53.84%in patients with CHF,HUA prevalence in patients of female,male were respectively52.95%,54.86%.The difference of HUA prevalence between female and male had no statistical significance(P>0.05).HUA prevalence in young group(male61.87%,female61.87%)was significantly higher than that in other age groups(P<0.05).HUA prevalence of NYHA classⅡ,NYHA classⅢ,NYHA classⅣwere respectively37.48%,53.99%and37.48%.The worse the cardiac function was,the higher the prevalence of HUA was.HUA prevalence in HFREF group was significantly higher than that in HFPEF group(65.76%vs.46.48%,P<0.05).The differences of HUA prevalences of different etiologies were statistically significant(P<0.05),and HUA prevalence of dilated cardiomyopathy was the highest with65.02%.Conclusions The prevalence of HUA in patients with CHF were high in Yunnan Province.HUA could be an independent risk factor of CHF.