1 Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.
J Intensive Care Med. 2019 May;34(5):404-410. doi: 10.1177/0885066617698911. Epub 2017 Mar 28.
: Uric acid acts as both a pathogenic inflammatory mediator and an antioxidative agent. Several studies have shown that uric acid level correlates with the incidence, severity, and prognosis of pulmonary diseases. However, the association between uric acid level and acute respiratory distress syndrome (ARDS) has not been studied. This study was conducted to elucidate how serum uric acid level is related with clinical prognosis of ARDS.
: A retrospective cohort study with propensity score matching was conducted at a medical intensive care unit of a tertiary teaching hospital. The medical records of patients diagnosed with ARDS admitted from 2005 through 2011 were reviewed.
: Two hundred thirty-seven patients with ARDS met the inclusion criteria. Patients with a serum uric acid level <3.0 mg/dL were classified into the low uric acid group, and those with a level ≥3 mg/dL were classified into the normal to high uric acid group. We selected 40 patients in each group using propensity score matching. A higher percentage of patients in the low uric acid group experienced clinical improvement in ARDS. More patients died from sepsis in the normal to high uric acid group. Kaplan-Meier analysis showed that a low serum uric acid level was significantly associated with better survival rate.
: In patients with ARDS, a low serum uric acid level may be a prognostic marker of a low risk of in-hospital mortality.
尿酸既是一种致病的炎症介质，也是一种抗氧化剂。多项研究表明，尿酸水平与肺部疾病的发病率、严重程度和预后相关。然而，尿酸水平与急性呼吸窘迫综合征（ARDS）之间的关联尚未得到研究。本研究旨在阐明血清尿酸水平与 ARDS 临床预后的关系。
采用回顾性队列研究和倾向评分匹配方法，在一家三级教学医院的重症监护病房进行。回顾性分析 2005 年至 2011 年间诊断为 ARDS 并入院的患者的病历。
符合纳入标准的 ARDS 患者有 237 例。将血清尿酸水平<3.0mg/dL 的患者分为低尿酸组，将水平≥3mg/dL 的患者分为正常至高尿酸组。使用倾向评分匹配，我们在每个组中选择了 40 名患者。低尿酸组中更多的患者在 ARDS 中出现临床改善。在正常至高尿酸组中，更多的患者因败血症死亡。Kaplan-Meier 分析显示，低血清尿酸水平与生存率的提高显著相关。
在 ARDS 患者中，低血清尿酸水平可能是院内死亡率低的预后标志物。
