不同射血分数心力衰竭患者黄嘌呤氧化酶与尿酸的表达及意义

Expression and analysis of Xanthine oxidase and uric acid in patients with different ejection fraction heart failure

目的比较黄嘌呤氧化酶(XO)及尿酸水平在不同射血分数心力衰竭患者中的差异及临床意义。方法选取120例心力衰竭患者,分成HFrEF组、HFmrEF组及HFpEF组,每组40例,同时选择40例无心力衰竭的、患有其他类型心血管病的患者作为对照组。收集入选者的临床资料,生化检测尿酸水平,用酶联免疫吸附法检测XO水平。结果与对照组相比,三组心力衰竭患者的XO、尿酸水平升高,组间比较差异具有统计学意义(F=60.257、19.024,均P<0.01)。Spearman相关分析显示:心力衰竭患者XO和尿酸水平与NT⁃proBNP呈正相关(r=0.571、0.404)、与LVEF呈负相关(r=-0.185、-0.270),差异具有统计学意义(均P<0.05)。多因素回归分析显示:不同射血分数心力衰竭的危险因素包括XO、尿酸,除此之外,冠心病病史是射血分数下降心力衰竭的危险因素,而房颤病史则是射血分数保留型心力衰竭的危险因素。结论血清XO、尿酸是心力衰竭患者的危险因素,对心衰患者的临床诊断具有一定的参考价值,甚至可能是评价心力衰竭患者心功能损害程度的重要指标。

Objective The study aimed to compare the difference and clinical significance of Xanthine oxidase and uric acid in heart failure(HF)patients with different ejection fraction.Methods A total of 120 HF patients were enrolled and divided into HFrEF group,HFmrEF group and HFpEF group,with 40 patients in each group respectively.Another 40 patients without heart failure but other types of cardiovascular diseases were selected as the control group.The clinical data were collected.The levels of uric acid(UA)and xanthine oxidase(XO)were determined by Enzyme Linked Immunosorbent Assay(ELISA).Results Compared with the control group,XO and UA levels in the three groups were all statistically increased(F=60.257,F=19.024,both P<0.01).Spearman correlation analysis showed that serum XO and UA levels in patients with heart failure were positively correlated with NT⁃proBNP(r=0.571,r=0.404)and negatively correlated with LVEF(r=-0.185,r=-0.270),with statistically significant differences(all P<0.05).Multivariate regression analysis showed that the risk factors for heart failure with different ejection fraction included XO and UA.In addition,history of coronary heart disease was a risk factor for heart failure with reduced ejection fraction,and history of atrial fibrillation was a risk factor for heart failure with retained ejection fraction.Conclusion XO and UA are risk factors for patients with heart failure.They have certain reference value for clinical diagnosis of patients with heart failure and may even be an important index to evaluate the degree of impairment of heart function in patients with heart failure.