血清尿酸水平与扩张型心肌病心衰患者的关系

目的：探讨扩张型心肌病心衰患者血清尿酸浓度的变化规律及其临床意义。方法：比较扩张型心肌病（DCM，96例）不同心功能和其他状态下的尿酸浓度。结果：DCM心功能Ⅱ、Ⅲ、Ⅳ级患者的尿酸分别为（303±34）mmol／L，（403±95）mmol／L和（595±190）mmol／L，各级间比较差异具有显著性（P〈0．01）；与心衰控制前比较，心衰控制后尿酸浓度明显降低[（609±218）mmol／L比（414±147）mmol／L，P〈0．01]；左室内径≥65mm者尿酸浓度明显高于〈65mm者[（572±183）mmol／L比（425±112）mmol／L，P〈0．01]；人院时服与未服利尿剂者尿酸浓度无明显差异（P〉0．05）；BUN〉7．5mmol／L与≤7．5mmol／L者尿酸浓度无明显差异（P〉0．05）。结论：扩张型心肌病心衰患者尿酸浓度升高，升高程度与心衰严重程度有关，而独立于服用利尿剂及肾功能不全；血清尿酸浓度是反映心衰患者病情严重程度的一个指标。

Relationship between level of serum uric acid and patients with dilated cardiomyopathy complicated heart failure and its clinical significance

Objective： To explore changing rules of serum concentrations of uric acid （UA） in patients with dilated cardiomyopathy （DCM） and heart failure （HF） and its clinical significance. Methods： Comparisons were performed among UA levels under different cardiac function classes and other conditions. Results： Concentrations of serum UA were （303±34） mmol/L, （403±95） mmol/L and （595±190） mmol/L in DCM patients with NYHA cardiac function class Ⅱ , Ⅲ , Ⅳ respectively （P〈0.01）; compared with before control, UA concentration [ （609±218） mmol/L vs. （414±147） mmol/L, P〈0. 011 significantly decreased in HF patients after control; UA level in patients with left ventricular inner dimension （LVID） ≥65mm was significantly higher than that in patients with LVID 〈65mm [ （572 ±183） mmol/L vs. （425±112） mmol/L, P〈0.01]; there were no significant difference in UA level among patients taking diuretics and those not taking at admission, patients with BUN）7.5mmol/L and those with BUN ≤7.5mmol/ L （P〉0.05）. Conclusion： UA level significantly increases in patients with DCM and HF, and is correlated with sever- ityof HF and independent from taking diuretics and renal dysfunction; serum level of UA is an index that can reflect severity of HF patients.