尿酸、胱抑素C在老年舒张性心力衰竭患者血清中的表达及其与心室重构的相关性

Expression of uric acid and cystatin C in serum of older adult patients with diastolic heart failure and their correlation with ventricular remodeling

目的探讨尿酸(UA)、胱抑素C(Cys C)在老年舒张性心力衰竭(DHF)患者血清中的表达及其与心室重构的相关性。方法回顾性分析辽宁省金秋医院2018年1月至2020年1月收治的老年DHF患者173例(病例组)及同期收治的心功能正常患者144例(对照组)的临床资料,比较两组左室舒张末期内径(LVEDd)、左心室质量指数(LVMI)、血清UA及Cys C水平,以及不同心功能分级DHF患者上述指标的变化。同时分析UA、Cys C水平与LVEDd和LVMI的相关性。结果病例组LVEDd、LVMI、UA、Cys C水平分别为(46.82±4.56)mm、(117.45±24.51)g/m2、(380.23±115.85)μmol/L、(1.41±0.51)mg/L,均明显高于对照组的(45.8±3.96)mm、(111.19±19.30)g/m2、(333.65±89.02)μmol/L、(1.06±0.34)mg/L,差异均有统计学意义(t=2.10、2.48、3.95、7.02,均P<0.05);UA水平在心功能Ⅳ级组为(432.48±157.64)μmol/L,明显高于心功能Ⅱ级组的(355.22±106.56)μmol/L和Ⅲ级组的(379.89±93.43)μmol/L(F=5.18、P<0.05);Pearson相关性分析显示,老年DHF患者UA与LVEDd(r=0.17,P<0.05)、LVMI(r=0.18,P<0.05)均呈正相关。结论血清UA、Cys C在老年人DHF发生、发展中起重要作用;UA水平可在一定程度上衡量心室重构程度。

Objective To investigate the expression of serum uric acid and cystatin C in older adult patients with diastolic heart failure and their correlation with ventricular remodeling.Methods The clinical data of 173 older adult patients with diastolic heart failure(patient group)and 144 older adult patients who had normal heart function(control group)who received treatment in Liaoning Jinqiu Hospital from January 2018 to January 2020 were retrospectively analyzed.Left ventricular end-diastolic diameter,left ventricular mass index,serum uric acid and cystatin C levels were compared between the two groups.These indices were also compared between patients with different classes of heart failure.Serum uric acid and cystatin C levels were correlated with left ventricular end-diastolic diameter and left ventricular mass index.Results Left ventricular end-diastolic diameter,left ventricular mass index,and serum uric acid and cystatin C levels in the patient group were(46.82±4.56)mm,(117.45±24.51)g/m2,(380.23±115.85)μmol/L,(1.41±0.51)mg/L,respectively,which were significantly higher than(45.8±3.96)mm,(111.19±19.30)g/m2,(333.65±89.02)μmol/L,(1.06±0.34)mg/L,respectively in the control group(t=2.10,2.48,3.95,7.02,all P<0.05).Serum uric acid level in patients with class IV heart failure was(432.48±157.64)μmol/L,which was significantly higher than(355.22±106.56)μmol/L and(379.89±93.43)μmol/L in patients with class II and class III heart failure(F=5.18,P<0.05).Pearson correlation analysis showed that serum uric acid level was positively correlated with left ventricular end-diastolic diameter(r=0.17,P<0.05)and left ventricular mass index(r=0.18,P<0.05)in older adult patients with diastolic heart failure.Conclusion Serum uric acid plays an important role in the occurrence and development of diastolic heart failure in older adults.Serum uric acid level can help measure the degree of ventricular remodeling to some extent.