老年心力衰竭患者ABCD期血清尿酸与脑钠肽前体检测的意义.docVIP

老年心力衰竭患者A、B、C、D期血清尿酸与脑钠肽前体检测的意义 作者：江琼　林军华 作者单位：1.福建医科大学附属协和医院心血管内科，福建 福州 350001；2.福建省冠心病研究所 【摘要】 目的：观察老年心力衰竭患者血清尿酸（UA）水平与脑钠肽前体(NT-proBNP)浓度与心力衰竭分期之间的关系。方法：282例老年心衰患者按美国慢性收缩性心力衰竭诊疗指南2001版分为A、B、C、D期4个亚组，健康体检者 50例作为对照组，分别测定各组血清UA水平和NT-proBNP浓度。结果：心衰患者血UA、NT-proBNP浓度较对照组显著升高（P分别0.05，＜0.01）；其水平在心衰各亚组随心衰病变程度加重而显著升高（各组两两比较，P分别为＜0.05，0.01）；相关分析表明，不同心功能分期的老年心衰患者UA与NT-proBNP呈正相关(r＝0.401，P＜0.01)。结论：心衰患者血清尿酸和血浆NT-proBNP浓度随心衰病变程度增加而升高，两者可联合作为评价老年心力衰竭严重程度的指标。 【关键词】 心力衰竭　充血性　尿酸　利钠肽　脑 　　Significance of serum uirc acid and pro-B-type natriuretic peptide in aged patients with heart failure 　　JIANG Qiong，LIN Junhua 　　Chinese Journal of Cardiovascular Rehabilitation Medicine,2009,18(6):533 　　Abstract：Objective:To evaluate the correlations of serum uric acid （UA）,N-terminal pro-B-type natriuretic peptide（NT-proBNP）levels and different heart failure stages in aged patients.Methods:The 282 cases of heart failure patients were classified as four stages(A,B,C,D) according to ACC/AHA 2001 guideline for chronic heart failure and 50 normal controls were enrolled．The levels of serum NT-proBNP and UA were detected respectively.Results:NT-proBNP and UA levels in heart failure patients increased compared with control group(P0.01,0.05 respectively),and increased with increment of heart faiure stages (compared between groups each other,P＜0.01,0.05 respectively）. The level of UA was positive correlation with NT-proBNP（r＝0.401，P＜0.01）.Conclusion:The level of NT-proBNP and UA increases with heart failure stages and can be combined to evaluate the severity of heart failure in aged patients. Author′s　address：Department of Cardiology，Union Hospital Affiliated to Fujian Medical University，Fuzhou,Fujian,350001,China 　　Key words：Heart failure,congestive；Uric acid;Natriuretic peptide,brain 　　尿酸(UA)是嘌呤代谢的终产物。大量流行病学和临床研究表明，血尿酸水平的升高与心血管疾病的发生、发展之间存在联系，是高血压、冠心病、高血脂等的独立危险因素，而心力衰竭作为各种心血管疾病的共同转归，血尿酸与其发生、发展、预后有着密切的关系[1～5]。美国2001年ACC/AHA心衰指南[6]把心力衰竭分为A、B、C、D期四个阶