血清尿酸水平对老年急性心衰患者病情变化的临床预测价值

发布时间：2018-06-29 12:58

本文选题：急性心力衰竭 + 尿酸　；参考：《中国老年学杂志》2016年09期

【摘要】：目的探讨血清尿酸(UA)对老年急性心力衰竭患者病情变化的临床预测价值。方法选取老年急性心力衰竭患者323例。入院后1 h内取静脉血行UA、N末端B型脑利钠肽前体(NT-pro BNP)、生化、血常规等检测,根据UA水平分组,比较各组患者就诊5 d及30 d后随访的死亡率,探讨UA对于老年急性心力衰竭患者死亡的预测价值。结果 (1)应用单因素方差分析比较各组患者就诊5 d及30 d死亡率,发现患者5d、30 d死亡率在低UA组与正常UA组间无显著差异,而正常UA与高UA组间有显著差异(9.4%vs 19%,P=0.018;21.3%vs 35%,P=0.010)。(2)应用ROC曲线分析UA的评估价值:1UA对于患者就诊5 d、30 d死亡率的AUROC分别为0.662和0.588,具有轻度的预测价值;2UA联合NTPro BNP对于急性心力衰竭预后具有更好的预测价值:UA联合NT-pro BNP对患者就诊5 d、30 d死亡率的AUROC分别升至0.701和0.702。结论虽然UA对急性心力衰竭的预后仅有轻度预测价值,但其预测价值与NT-pro BNP相当;将UA联合NT-pro BNP进行检测,可以进一步提高NT-pro BNP对急性心力衰竭患者死亡的预测价值。
[Abstract]:Objective to investigate the clinical predictive value of serum uric acid (UA) in elderly patients with acute heart failure. Methods 323 elderly patients with acute heart failure were selected. The venous blood was collected within 1 hour after admission for the detection of N-terminal B-type brain natriuretic peptide precursor (NT-pro BNP), biochemistry and blood routine. According to the UA level, the mortality of the patients in each group was compared after 5 days and 30 days follow-up. To investigate the predictive value of UA in elderly patients with acute heart failure. Results (1) single factor variance analysis was used to compare the mortality of 5 days and 30 days in all groups. The results showed that there was no significant difference between the low UA group and the normal UA group. There was significant difference between normal UA group and high UA group (9.4%vs 19: P0.018 + 21.3 vs 35g / kg P0.010). (2). The evaluation value of UA by ROC curve analysis was 0.662 and 0.588 for 5 days and 30 days, respectively. There was a slight predictive value of 2UA combined with NTPro BNP for acute heart disease. The prognosis of force failure has a better prognostic value: the AUROC of 30 days death rate in patients treated with NT-pro BNP increased to 0.701 and 0.702 respectively in combination with NT-pro BNP. Conclusion the prognostic value of UA in patients with acute heart failure is only mild, but its predictive value is similar to that of NT-pro BNP, and the detection of UA combined with NT-pro BNP can further improve the predictive value of NT-pro BNP in patients with acute heart failure.
【作者单位】：首都医科大学宣武医院急诊科;
【基金】：卫生行业科研专项项目(201002011) 首发基金项目资助(2009-SHF04)
【分类号】：R541.6

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