摘要
目的 探讨急性心力衰竭患者(acute heart failure, AHF)入院后不同血清尿酸(serum uric acid, SUA)水平对出院后心衰易损期心脏全因死亡以及心衰再入院(major adverse cardiac events, MACE)事件发生的影响。方法 收集陆军军医大学第二附属医院心血管内科自2019年10月至2021年7月收治AHF患者的临床资料,随访3个月,根据患者出院后易损期内是否发生MACE事件分为事件组与对照组,比较两组患者基线数据之间的差异,并对可能影响易损期MACE事件的因素进行多因素Logistic回归分析,探讨高SUA与AHF患者心衰易损期内预后的相关性。结果 共纳入539例AHF住院患者,事件组194例(35.9%),对照组345例(64.1%)。其中事件组高SUA 175例(90.3%),正常SUA 19例(9.7%),两者差异有统计学意义(P<0.05)。与对照组比较,事件组的SUA、D-二聚体、尿素氮、脑钠肽(BNP)水平和NYHA心功能分级、左心房前后径、左心室横径水平更高(P<0.05),而体质量指数(BMI)、平均动脉压、血钠、白蛋白、总胆固醇(TC)水平更低(P<0.05)。Logistic回归分析显示,高SUA(OR:3.419,95%CI:1.805~6.477,P<0.05)是易损期MACE事件的独立危险因素。结论 高SUA的AHF患者出院后易损期内MACE事件发生率高,有助于评估AHF患者易损期预后。
Objective To investigate the relationship between different serum uric acid(SUA) levels after admission and the incidence of cardiac major adverse cardiac events(MACE) in the vulnerable stage of heart failure after discharge in patients with acute heart failure(AHF). Methods Clinical data of AHF patients admitted to our department from October 2019 to July 2021 were collected, and all of them were followed up for 3 months. According to whether MACE events occurred during the vulnerable period after discharge, the patients were divided into event group and control group. The differences of the baseline data were compared between the 2 groups, and the factors that may affect the MACE events in the vulnerable period were analyzed with multivariate logistic regression analysis. The correlation between high SUA level and prognosis in the vulnerable period was analyzed. Results A total of 539 hospitalized AHF patients were included in this study, including 194(35.9%) in the event group and 345(64.1%) in the control group. In the event group, 175 cases(90.3%) had high SUA level and 19 cases(9.7%) had normal SUA level(P<0.05). The event group had higher levels of SUA, D-dimer, blood urea nitrogen, brain natriuretic peptide(BNP) and NYHA cardiac function class, left atrial anteroposterior diameter, and left ventricular transverse diameter(P<0.05), while lower body mass index(BMI), mean arterial pressure, serum sodium, albumin, and total cholesterol(TC)(P<0.05). Logistic regression analysis showed that high SUA(OR=3.419, 95%CI: 1.805~6.477, P<0.05) was an independent risk factor for MACE events in the vulnerable period of AHF patients. Conclusion The AHF patients with high SUA level are prone to the occurrence of MACE events in the vulnerable period after discharge. SUA is a helpful indicator for evaluating the prognosis of AHF patients in the vulnerable period.
作者
何小龙
罗晓宇
郭志念
胡华娟
陈运龙
成小凤
李平
何永铭
王江
HE Xiaolong;LUO Xiaoyu;GUO Zhinian;HU Huajuan;CHEN Yunlong;CHENG Xiaofeng;LI Ping;HE Yongming;WANG Jiang(Department of Cardiology,PLA Institute of Cardiovascular Diseases,Second Affiliated Hospital,Army Medical University(Third Military Medical University),Chongqing,400037,China)
出处
《陆军军医大学学报》
CAS
CSCD
北大核心
2022年第8期812-817,共6页
Journal of Army Medical University
关键词
血清尿酸
心衰易损期
急性心力衰竭
主要心脏不良事件
serum uric acid
vulnerable period of heart failure
acute heart failure
major adverse cardiac events
