摘要
目的探讨血尿酸(SUA)轨迹与急性心力衰竭(AHF)患者临床救治效果的关系。方法选取2022年2年至2024年2月安徽省第二人民医院收治的AHF患者100例,均接受规范治疗。收集不同时间点测量的SUA数据,并通过潜分类增长模型识别SUA发展轨迹,根据SUA水平分为SUA低轨迹组(56例)、SUA中轨迹组(32例)和SUA高轨迹组(12例),根据临床救治效果分为有效组(77例)和无效组(23例)。采用多因素Logistic回归分析SUA轨迹对AHF患者临床救治效果的影响及影响AHF患者临床救治效果的独立危险因素。结果100例AHF患者入院时、治疗14 d时、治疗结束时、治疗结束后3个月各时点SUA水平分别为(620.52±102.20)μmol/L、(415.50±82.55)μmol/L、(285.50±60.25)μmol/L、(200.40±20.25)μmol/L,总体呈下降趋势(F=627.844,P<0.05)。SUA低轨迹组、SUA中轨迹组、SUA高轨迹组心功能分级(Ⅲ~Ⅳ级)、血肌酐、N末端B型钠尿肽前体水平比较,差异有统计学意义(P<0.05)。SUA低轨迹组、SUA中轨迹组、SUA高轨迹组治疗后无效率比较,差异有统计学意义(10.71%vs 31.25%vs 58.33%,Z=8.313,P<0.05)。多因素Logistic回归分析显示,心功能分级(Ⅲ~Ⅳ级)、N末端B型钠尿肽前体、肌钙蛋白I、非高密度脂蛋白胆固醇与高密度脂蛋白胆固醇比值、SUA、SUA高轨迹是影响AHF患者临床救治效果的独立危险因素(OR=1.722,95%CI:1.252~2.229,P<0.01;OR=1.863,95%CI:1.453~2.272,P<0.01;OR=1.893,95%CI:1.396~2.389,P<0.01;OR=1.900,95%CI:1.406~2.395,P<0.01;OR=1.853,95%CI:1.470~2.237,P<0.01;OR=1.835,95%CI:1.465~2.205,P<0.01)。结论AHF患者SUA水平存在群体异质性,且SUA水平变化与临床救治效果有关。
Objective To investigate the relationship between serum uric acid(SUA)trajectory and clinical treatment efficacy in patients with acute heart failure(AHF).Methods A total of 100 patients with AHF admitted to Anhui No.2 Provincial People's Hospital from February 2022 to February 2024 were selected,and all received standardized treatment.SUA data measured at different time points were collected,and SUA development trajectories were identified using latent class growth modeling.Patients were classified into a low SUA trajectory group(56 cases),a medium SUA trajectory group(32 cases),and a high SUA trajectory group(12 cases)based on SUA levels,and were further divided into an effective group(77 cases)and an ineffective group(23 cases)according to clinical treatment outcomes.Multivariable Logistic regression was used to analyze the influence of SUA trajectory on clinical treatment outcomes in AHF patients and to identify independent risk factors affecting clinical treatment outcomes.Results The SUA levels in 100 AHF patients at admission,14 days of treatment,end of treatment,and 3 months after treatment were(620.52±102.20)μmol/L,(415.50±82.55)μmol/L,(285.50±60.25)μmol/L,and(200.40±20.25)μmol/L,respectively,showing an overall decreasing trend(F=627.844,P<0.05).There were significant differences among the low,medium,and high SUA trajectory groups in cardiac function classification(classⅢ–Ⅳ),serum creatinine levels,and N-terminal pro-B-type natriuretic peptide levels(P<0.05).The inefficiency rates after treatment differed significantly among the low,medium,and high SUA trajectory groups(10.71%vs 31.25%vs 58.33%;Z=8.313,P<0.05).Multivariable Logistic regression analysis showed that cardiac function classification(classⅢ–Ⅳ),N-terminal pro-B-type natriuretic peptide,cardiac troponin I,non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio,SUA level,and high SUA trajectory were independent risk factors affecting clinical treatment outcomes in AHF patients(OR=1.722,95%CI:1.252–2.229,P<0.01;OR=1.863,95%CI:1.453–2.272,P<0.01;OR=1.893,95%CI:1.396–2.389,P<0.01;OR=1.900,95%CI:1.406–2.395,P<0.01;OR=1.853,95%CI:1.470–2.237,P<0.01;OR=1.835,95%CI:1.465–2.205,P<0.01).Conclusion There is population heterogeneity in SUA levels among AHF patients,and changes in SUA levels are associated with clinical treatment outcomes.
作者
许恩文
李雪奇
李世光
张庆斌
张瑞雷
XU Enwen;LI Xueqi;LI Shiguang;ZHANG Qingbin;ZHANG Ruilei(Department of Cardiovascular Medicine,Anhui No.2 Provincial People's Hospital,Hefei,Anhui 230041,China)
出处
《转化医学杂志》
2025年第9期37-41,共5页
Translational Medicine Journal
基金
安徽省高校自然科学研究项目(ZR2021B006)。
关键词
急性心力衰竭
血尿酸轨迹
临床救治效果
队列研究
acute heart failure
serum uric acid trajectory
clinical treatment efficacy
cohort study
