Li Zhen-nan, He Jian-guo, Liu Zhi-hong, Gu Qing, Ni Xin-hai, Cheng Xian-sheng, Xiong Chang-ming
State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, China.
Zhonghua Yi Xue Za Zhi. 2012 Dec 11;92(46):3261-4.
To explore the relationship between serum uric acid levels and patient conditions and prognosis in idiopathic pulmonary arterial hypertension (IPAH).
A total of 76 IPAH patients confirmed by right heart catheterization were enrolled consecutively and followed up until the endpoint of all-cause death. Their baseline data were recorded and analyzed by Spearman's rank test and independent t-test. And the follow-up outcomes were analyzed with Kaplan-Meier plots.
There were 27 males and 49 females with a mean age of 29.7 ± 9.7 years. They were classified into World Health Organization functional class (WHO-FC)II (n = 28), class III (n = 45) and class IV (n = 3). Their baseline mean pulmonary artery pressure was (65 ± 16) mm Hg, pulmonary vascular resistance (1677 ± 669) dyn×s(-1)×cm(-5), pulmonary capillary wedge pressure (9.6 ± 5.0) mm Hg, mean right atrial pressure (9.8 ± 6.1) mm Hg, cardiac index (2.07 ± 0.57) L ×min(-1)× m(-2) and serum uric acid (391 ± 103) µmol/L. The correlation analysis indicated that the serum level of uric acid correlated positively with right ventricular diameter (r = 0.28, P = 0.018) and negatively with CI (r = -0.34, P = 0.003). Independent t-test results indicated that the patients with a higher level of uric acid were apt to have a worse WHO-FC, and the higher level uric acid group (serum uric acid > 416.5 µmol/L) had a relative higher level of WHO-FC, NT-proBNP and endothelin-1. A lower level of CI denoted more severe conditions and prognosis. Survival analysis indicated that the serum level of uric acid could strongly predict survival in IPAH patients with over time and those with a high level of uric acid had a worse prognosis.
The serum level of uric acid correlates significantly with patient conditions and prognosis in IPAH. And a higher serum level of uric acid predicts worse conditions and prognosis.
探讨特发性肺动脉高压(IPAH)患者血清尿酸水平与病情及预后的关系。
连续纳入76例经右心导管检查确诊的IPAH患者,随访至全因死亡终点。记录其基线数据,采用Spearman秩相关检验和独立样本t检验进行分析。采用Kaplan-Meier曲线分析随访结局。
共纳入76例患者,其中男性27例,女性49例,平均年龄(29.7±9.7)岁。根据世界卫生组织功能分级(WHO-FC)分为Ⅱ级(n = 28)、Ⅲ级(n = 45)和Ⅳ级(n = 3)。其基线平均肺动脉压为(65±16)mmHg,肺血管阻力为(1677±669)dyn×s(-1)×cm(-5),肺毛细血管楔压为(9.6±5.0)mmHg,平均右心房压为(9.8±6.1)mmHg,心脏指数为(2.07±0.57)L×min(-1)×m(-2),血清尿酸为(391±103)μmol/L。相关性分析显示,血清尿酸水平与右心室直径呈正相关(r = 0.28,P = 0.018),与心脏指数呈负相关(r = -0.34,P = 0.003)。独立样本t检验结果显示,尿酸水平较高的患者WHO-FC较差,尿酸水平较高组(血清尿酸>416.5μmol/L)的WHO-FC、N末端脑钠肽前体(NT-proBNP)和内皮素-1水平相对较高。心脏指数较低表明病情更严重,预后更差。生存分析显示,血清尿酸水平可有力预测IPAH患者的长期生存情况,尿酸水平高的患者预后较差。
IPAH患者血清尿酸水平与病情及预后显著相关,血清尿酸水平较高预示病情及预后较差。