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目的通过观察急性心力衰竭(HF)患者血清尿酸(UA)及B型尿钠肽(BNP)水平的变化,进一步探讨其临床意义。方法 80例健康体检者为对照组,80例经临床确诊的HF患者为观察组,采用彩色多普勒超声诊断仪检测左室射血分数(LVEF);采用全自动生化分析仪测定血清UA水平;采用免疫分析仪检测BNP水平;观察组治疗3 w~4 w后复查超声心动图及UA、BNP水平,进一步观察治疗前后各指标变化及UA、BNP水平与LVEF的相关性。结果观察组血清UA、BNP水平明显高于对照组,LVEF明显低于对照组(P<0.05或P<0.O1);HF控制后血清UA、BNP水平明显降低(P<0.O1);血清UA、BNP浓度、LVEF三者之间密切相关,血清UA与BNP水平呈正相关(r=0.723,P<0.05);血清UA与LVEF相关性分析呈负相关(r=-0.611,P<0.05);血BNP水平与LVEF呈负相关(r=-0.719,P<0.05)。结论血清UA、BNP水平变化对HF诊断、严重程度及预后评价有重要临床应用价值。
Objective To investigate the clinical significance of the changes of serum uric acid (UA) and type-B natriuretic peptide (BNP) in patients with acute heart failure (HF). Methods Eighty healthy subjects were selected as the control group. Eighty patients with clinically diagnosed HF were selected as observation group. Left ventricular ejection fraction (LVEF) was measured by color Doppler sonography. Serum UA levels were measured by automatic biochemical analyzer The level of BNP was measured by immunoanalyzer. The echocardiography and UA and BNP levels in the observation group were observed after 3 w ~ 4 w of treatment. The changes of each index and the correlation between the levels of UA and BNP and LVEF were observed. Results The levels of serum UA and BNP in the observation group were significantly higher than those in the control group (P <0.05 or P <0.01), while the levels of serum UA and BNP in HF group were significantly decreased (P <0.01). Serum UA, BNP concentration and LVEF were closely related, serum UA and BNP levels were positively correlated (r = 0.723, P <0.05); serum UA was negatively correlated with LVEF (r = -0.611, P <0.05 ); BNP level was negatively correlated with LVEF (r = -0.719, P <0.05). Conclusion The changes of serum UA and BNP level have important clinical value in the diagnosis, severity and prognosis of HF.