慢性心力衰竭患者血尿酸水平动态变化及与NT-proBNP、心功能的相关性

Dynamic changes of serum uric acid level and its correlation with NT-proBNP and cardiac function in patients with chronic heart failure

目的探讨慢性心力衰竭患者血清尿酸水平动态变化及与N端脑钠肽前体(NT-proBNP)、心功能的相关性。方法随机选取2018年1月至2018年12月本院收治的30例慢性心力衰竭(CHF)患者作为观察组研究对象,另选取同期来本院进行体检的30例健康者作为对照组,分别检测并比较两组患者的血尿酸(UA)、NT-proBNP水平及左室射血分数(LVEF)、左室舒张末期内径(LVEDD)等指标。观察CHF患者治疗前后UA、NT-proBNP水平变化情况,分析不同心功能分级患者各指标水平变化情况,采用直线相关分析法进一步对CHF患者UA、NT-proBNP动态水平变化与心功能的相关性进行分析。结果观察组患者临床UA、NT-proBNP均明显高于对照组,LVEDD指标亦较对照组明显增加,LVEF较对照组明显降低(P<0.05);CHF患者治疗后的UA、NT-proBNP水平均较治疗前明显下降(P均<0.05);随着心功能分级的增加,CHF患者UA、NT-proBNP水平水平随之增加(P均<0.05)。相关性分析显示,CHF患者的UA、NT-proBNP水平与其心功能NYHA分级及LVEDD大小均呈明显正相关(P<0.05),与其临床LVEF指标均呈明显负相关性,差异具有统计学意义(P<0.05)。结论慢性心力衰竭患者的临床血尿酸与N端脑钠肽前体水平不仅会随其心功能NYHA分级及LVEDD值的增加而升高,且与LVEF指标具有较好的相关性,其对CHF疾病的诊断、预后评估均具有重要临床价值。

Objective To explore the dynamic changes of serum uric acid level and its correlation with N terminal pro brain natriuretic peptide(NT-proBNP)and cardiac function in patients with chronic heart failure.Methods 30 patients with chronic heart failure(CHF)treated in our hospital from January 2018 to December 2018 were selected as the subjects of the observation group,and 30 healthy persons who had been examined in our hospital for the same period were selected as the control group.The serum uric acid(UA),NT-proBNP level,left ventricular ejection fraction(LVEF)and left ventricular end diastolic diameter(LVEDD)and other indicators were measured and compared in the two groups.The changes of the level of UA and NT-proBNP before and after the treatment of CHF patients were observed,and the changes of the indexes of the patients with different cardiac function classification were analyzed.The correlation between the dynamic level of UA and NT-proBNP and the correlation of cardiac function of the patients with CHF was further analyzed by linear correlation analysis.Results The clinical UA and NT-proBNP in the observation group were significantly higher than those in the control group,and the LVEDD index was also significantly higher than the control group,and the LVEF was significantly lower than the control group(P<0.05).The level of UA and NT-proBNP after the treatment of CHF patients was significantly lower than that before the treatment(P<0.05).With the increase of cardiac function,the levels of UA and NT-proBNP in CHF patients increased(P<0.05).The correlation analysis showed that the levels of UA and NT-proBNP in CHF patients were positively correlated with the NYHA classification and LVEDD size of their heart function(P<0.05),and had a significant negative correlation with the clinical LVEF index,and the difference was also statistically significant(P<0.05).Conclusion The level of serum uric acid and N terminal brain natriuretic peptide(BNP)in patients with chronic heart failure will not only increase with the increase of cardiac function NYHA classification and LVEDD value,but also have a good correlation with the LVEF index.It has important clinical value for the diagnosis and prognosis evaluation of CHF disease.