Njaman Widi, Iesaki Takafumi, Iwama Yoshitaka, Takasaki Yoshinari, Daida Hiroyuki
Department of Cardiovascular Medicine, Juntendo University School of Medicine, Tokyo, Japan.
Int Heart J. 2007 Jul;48(4):523-32. doi: 10.1536/ihj.48.523.
Pulmonary arterial hypertension (PAH) has been identified as a life threatening complication of connective tissue disease. However, the association between serum uric acid (UA) levels and long-term outcome in PAH with connective tissue disease has not been evaluated. We therefore assessed whether serum UA levels are related to the mortality of such patients.
We investigated 90 consecutive patients with connective tissue disease who were initially diagnosed with PAH by echocardiography, and assessed the long-term clinical outcome in populations with higher (> or = 4.7 mg/dL) and lower serum UA levels. Kaplan-Meier analysis showed that patients with higher median serum UA values had a significantly worse survival rate for any cause of death (54.5% versus 84.7%, log-rank, P < 0.01) and PAH-related death (72.7% versus 93.4%, log-rank, P < 0.01) than those with low values. Multivariate analysis showed that an elevated serum UA level was an independent predictor for survival (hazard ratio, 1.88, 95% CI [1.24- 2.84], P < 0.01).
Elevated serum UA levels are associated with a poor prognosis and can serve as a prognostic predictor for patients with PAH secondary to connective tissue disease.
肺动脉高压（PAH）已被确认为结缔组织病的一种危及生命的并发症。然而，血清尿酸（UA）水平与结缔组织病相关PAH的长期预后之间的关联尚未得到评估。因此，我们评估了血清UA水平是否与此类患者的死亡率相关。
我们调查了90例最初通过超声心动图诊断为PAH的结缔组织病患者，并评估了血清UA水平较高（≥4.7mg/dL）和较低人群的长期临床结局。Kaplan-Meier分析显示，血清UA中位数较高的患者因任何原因死亡的生存率（54.5%对84.7%，对数秩检验，P<0.01）和PAH相关死亡的生存率（72.7%对93.4%，对数秩检验，P<0.01）均显著低于血清UA中位数较低的患者。多变量分析显示，血清UA水平升高是生存的独立预测因素（风险比，1.88，95%CI[1.24-2.84]，P<0.01）。
血清UA水平升高与预后不良相关，可作为结缔组织病继发PAH患者的预后预测指标。
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