慢性肺心病患者治疗前后血尿酸变化1例分析并文献复习

Analysis of the change of serum uric acid level in one patient with chronic pulmonary heart disease and literature review

目的探讨1例慢性肺心病患者治疗前后血尿酸水平的变化,以便进行治疗疗效及预后评估。方法患者,男,62岁,因“反复咳嗽、咳痰10年,加重伴胸闷、气促10d”于2017年11月16日入院,入院后完善血气分析、血常规、血沉、血凝常规、血生化、NT-ProBNP、肌钙蛋白、胸部CT、心脏超声、心电图等检查,诊断为“慢性肺心病、心功能不全、心功能III级(NYHA)、慢性阻塞性肺疾病、高血压”。结果给予患者吸氧、抗感染、解痉平喘、利尿、降压等对症治疗,入院时患者查血尿酸610.0μmol/L,病情好转后复查血尿酸降至325.0μmol/L,期间未予降尿酸药物。结论慢性肺心病合并心功能不全患者经过纠正缺氧、改善心功能等治疗,升高的血尿酸水平可显著下降,与心肺功能改善有关,也是预后较好的标志。

Objective To explore the change of serum uric acid level during the treatment of chronic pulmonary heart disease,in order to evaluate the treatment effect and prognosis.Methods The patient was a 62 years old male.He came to hospital because of repeated cough for 10 years,chest tightness and shortness of breath for 10 days on 2017.11.16.After being hospitalized,blood gas analysis,routine blood test,blood sedimentation,blood clot routine,biochemical tests,NT-ProBNP,troponin,chest CT,heart ultrasound,and electrocardiogram were taken.Finally,he was diagnosed as chronic pulmonary heart disease,cardiac dysfunction,class III(NYHA)cardiac function,chronic obstructive pulmonary disease,and hypertension.Results The main treatment measures included oxygen inhalation,antibiotics,antiasthma,dieresis,and antihypertensive.The serum uric acid level was reduced from 610.0 μmol/L to 325.0 μmol/L after the treatment,at the same time the patient’s symptoms were improved significantly.Conclusions After improving hypoxia and heart insufficiency,the elevated serum uric acid level would decrease in the patient with chronic pulmonary heart disease and cardiac dysfunction.The lower serum uric acid level can be used as a reliable index in evaluating the patient’s prognosis.