Zhang Yu-Hui, Lü Rong, Zhao Xue-Yan, Kang Lian-Ming, Yang Yue-Jin, Zhang Jian
Department of Cardiology, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2009 Feb;37(2):126-9.
To explore the correlation of serum uric acid, invasive hemodynamic parameters, plasma N-terminal proBNP (NT-proBNP) and Hs-C reactive protein (Hs-CRP) in patients with heart failure.
Invasive hemodynamic parameters derived from Swan-Ganz catheter, serum uric acid, plasma NT-proBNP and Hs-CRP within 12 hours after hospital admission were analyzed in 141 patients with chronic heart failure [New York Heart Association (NYHA) class II-IV].
Incidence of hyperuricemia was 55.30% in this patient cohort. Pulmonary capillary wedge pressure (PCWP) and plasma NT-proBNP in hyperuricemia patients were significantly higher than those in non-hyperuricemia patients (P < 0.01). The percentages of high plasma NT-proBNP (> 600 pmol/L) and hyperuricemia were significantly higher in patients with PCWP > or = 18 and < 28 mm Hg (1 mm Hg = 0.133 kPa) and patients with PCWP > or = 28 mm Hg compared those in patients with PCWP < 18 mm Hg, (P = 0.01, P = 0.02; P < 0.01, P < 0.01, respectively). Partial correlation analysis showed that serum uric acid correlated with right atrial pressure, right ventricular pressure, pulmonary arterial pressure and PCWP (r = 0.19, P = 0.03; r = 0.45, P < 0.01; r = 0.23, P = 0.01; r = 0.24, P = 0.01, respectively). Multiple linear regression analysis showed both serum uric acid and plasma NT-proBNP correlated independently with PCWP (beta = 0.24, P = 0.01; beta = 0.47, P < 0.01, respectively) while plasma Hs-CRP and left ventricular ejection fraction were not correlated with serum uric acid and PCWP (P > 0.05).
Serum uric acid independently correlated with PCWP in patients with heart failure and the combined measurements of serum uric acid and plasma NT-proBNP are helpful in evaluating the prognosis of patients with heart failure.
探讨心力衰竭患者血清尿酸、有创血流动力学参数、血浆N末端B型利钠肽原（NT-proBNP）和超敏C反应蛋白（Hs-CRP）之间的相关性。
对141例慢性心力衰竭患者[纽约心脏协会（NYHA）心功能Ⅱ-Ⅳ级]入院后12小时内通过Swan-Ganz导管测得的有创血流动力学参数、血清尿酸、血浆NT-proBNP和Hs-CRP进行分析。
该患者队列中高尿酸血症的发生率为55.30%。高尿酸血症患者的肺毛细血管楔压（PCWP）和血浆NT-proBNP显著高于非高尿酸血症患者（P<0.01）。PCWP≥18且<28 mmHg（1 mmHg = 0.133 kPa）的患者以及PCWP≥28 mmHg的患者中，血浆NT-proBNP>600 pmol/L和高尿酸血症的百分比显著高于PCWP<18 mmHg的患者（分别为P = 0.01，P = 0.02；P<0.01，P<0.01）。偏相关分析显示血清尿酸与右心房压、右心室压、肺动脉压和PCWP相关（r分别为0.19，P = 0.03；r = 0.45，P<0.01；r = 0.23，P = 0.01；r = 0.24，P = 0.01）。多元线性回归分析显示血清尿酸和血浆NT-proBNP均与PCWP独立相关（β分别为0.24，P = 0.01；β = 0.47，P<0.01），而血浆Hs-CRP和左心室射血分数与血清尿酸和PCWP无关（P>0.05）。
心力衰竭患者血清尿酸与PCWP独立相关，血清尿酸和血浆NT-proBNP联合检测有助于评估心力衰竭患者的预后。
