慢性心力衰竭患者血尿酸、胆红素和超敏C反应蛋白水平变化的临床意义

目的探讨慢性心力衰竭（CHF）患者血尿酸（UA）、胆红素和超敏C反应蛋白（hs—CRP）水平变化的临床意义。方法选择110例慢性心力衰竭患者为CHF组，按NYHA心功能分级分为3组：心功能Ⅱ级36例，心功能Ⅲ级62例，心功能Ⅳ级12例。另外选取在本院体检的心功能正常者50名作为对照组。所有入选者于人院第2天采空腹静脉血测定UA、胆红素和hs—CRP水平。结果CHF组UA、胆红素和hs—CRP水平明显高于对照组且差异具有统计学意义（P〈O．05）；CHF组内不同心功能分级组间UA和胆红素水平比较差异有统计学意义（P〈0．05），而hs—CRP差异无统计学意义（P〉O．05）。UA、胆红素和hs—CRP与年龄无相关性（P〉O．05）；UA和胆红素与心功能分级呈显著正相关（P〈O．05），hs—CRP与心功能分级无相关性（P〉0．05）。结论血UA、胆红素和hs—CRP水平升高在CHF发生、发展中起一定作用。血UA、胆红素水平随心力衰竭程度加重而升高，hs—CRP水平变化在CHF发生、发展中可能无确定作用。检测血尿酸、胆红素水平有助于判断心衰严重程度并指导临床治疗。

Clinical significance of uric acid bilirubin and high-sensitivity C-reaction protein levels in patients with chronic heart failure

Objective To investigate clinical significance of uric acid biliruhin and high-sensitivity Creaction protein level change in patients with chronic heart failure. Methods 110 patients with chronic heart failure were divided into three groups according to NYHA heart function class： 36 cases of grade 11 heart function, 62 eases of grade III, grade 1V heart function in 12 patients. Meanwhile 50 cases with normal heart function who had physical examination in our hospital were selected as the control group. The level of UA, bilirubin and hs-CRP on second day were measured by collected fasting venous blood in the hospital. Results UA, bilirubin and hs-CRP levels in CHF group were obviously higher than control group （P〈0.05）. In CHF group among different cardiac function, UA and bflirubin levels had statistical significance （P〈0.05）, where there was no statistical significance （P〉0.05） in hs-CRP level; UA, bilirubin and hs-CRP have no relation to age （P〉0.05）. UA and bilirubin were obviously positive relation to cardiac function class（P〈0.05 ）, while hs-CRP was irrelative to cardiac function class （P〉0.05）. Conclusion Blood UA, bilirubin and hs-CRP levels may play an important role in development of CHF, Blood UA and bilirubin levels rising with increasing of extent of heart failure. Hs-CRP level change has uncertain relationship with the development of CHF. Evaluation of blood UA and bilirubin levels are useful to deter- mine the severity of heart failure and guide clinical treatment.