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目的分析血清尿酸(SUA)水平与重度慢性收缩性心力衰竭(CHF)患者预后的关系。方法收集2014年4月~2015年1月于我院住院纽约心脏病协会(NYHA)心功能Ⅳ级CHF患者189例,对其随访6个月,终点事件为全因死亡。分析入院SUA水平与CHF住院患者6个月内全因死亡的关系。结果按随访结果将患者分为死亡组和存活组。死亡组入院SUA水平明显高于存活组[(514±30)μmol/L vs.(432±32)μmol/L,P<0.01]。Pearson分析显示N末端脑钠尿肽前体(NT-proBNP)与SUA具有正相关性(r=0.345,P<0.05)。多因素Logistic回归分析显示,SUA水平(OR=1.213,95%CI:1.081-3.621,P<0.05),NT-proBNP(OR=1.456,95%CI:1.113-5.432,P<0.01),糖尿病(OR=2.105,95%CI:1.221-4.553,P<0.05)是CHF患者6个月全因死亡事件发生的独立危险因素。结论血清SUA水平与重度CHF预后有相关性。
Objective To analyze the relationship between the level of serum uric acid (SUA) and the prognosis of patients with severe chronic systolic heart failure (CHF). Methods A total of 189 CHF patients with NYHA class Ⅳ CHF who were admitted to our hospital from April 2014 to January 2015 were enrolled in this study. All patients were followed up for 6 months. The end point was all-cause death. The relationship between SUA admission and all-cause mortality in CHF patients within 6 months was analyzed. Results According to the follow-up results, patients were divided into death group and survival group. The SUA level in the death group was significantly higher than that in the survival group [(514 ± 30) μmol / L vs. (432 ± 32) μmol / L, P <0.01]. Pearson analysis showed a positive correlation between N-terminal pro-brain natriuretic peptide (NT-proBNP) and SUA (r = 0.345, P <0.05). Multivariate Logistic regression analysis showed that the levels of SUA (OR = 1.213, 95% CI: 1.081-3.621, P0.05), NT-proBNP (OR = 1.456,95% CI: 1.113-5.432, OR = 2.105, 95% CI: 1.221-4.553, P <0.05) were independent risk factors of all-cause death in 6 months in CHF patients. Conclusions Serum SUA levels are associated with the prognosis of severe CHF.