摘要:Objective To explore the correlation of serum uric acid, invasive hemodynamic parameters, plasma N-terminal proBNP (NT-proBNP) and Hs-C reactive protein (Hs-CRP)in patients with rnheart failure. Method Invasive hemodynamic parameters derived from Swan-Ganz catheter, serum uric acid, plasma NT-proBNP and Hs-CRP within 12 hours after hospital admission were analyzed in 141 patients with chronic heart failure [New York Heart Association (NYHA) class Ⅱ - Ⅳ ]. Results Incidence of hyperuricemia was 55.30% in this patient cohort. Pulmonary capillary wedge pressure(PCWP) and plasma NT-proBNP in hyperuricemia patients were significantly higher than those in non-hyperuricemia patients(P <0.01). The percentages of high plasma NT-proBNP ( > 600 pmol/L) and hyperuricemia were significantly higher in patients with PCWP≥18 and < 28 mm Hg (1 mm Hg =0.133 kPa) and patients with PCWP≥28mm Hg compared those in patients with PCWP < 18 mm Hg, (P=0.01, P=0.02 ; P < 0.01, P < 0.01,respectively). Partial correlation analysis showed that serum uric acid correlated with right atrial pressure,right ventricular pressure, pulmonary arterial pressure and PCWP (r=0.19, P=0.03 ; r=0.45, P < 0.01 ;r=0.23,P=0.01 ; r=0.24, P=0.01, respectively). Multiple linear regression analysis showed both serum uric acid and plasma NT-proBNP correlated independently with PCWP (β=0.24, P=0.01;β=0.47, P <0.01, respectively) while plasma Hs-CRP and left ventricular ejection fraction were not correlated with serum uric acid and PCWP (P > 0.05). Conclusion Serum uric acid independently correlated with PCWP in patients with heart failure and the combined measurements of serum uric acid and plasma NT-proBNP are rnhelpful in evaluating the prognosis of patients with heart failure.%目的 评价心力衰竭(心衰)患者血尿酸与有创血液动力学监测指标、血浆N末端B型利钠肽原(NT-proBNP)和高敏C反应蛋白(Hs-CRP)的相关性.方法 选择141例NYHA Ⅱ~Ⅳ级心衰患者,在入院12 h内行漂浮导管监测和血尿酸等常规检查,同时检测血浆NT-proBNP和Hs-ClIP.结果 高尿酸血症的比率为55.30%,肺毛细血管楔压(PCWP)在高尿酸血症总组及高尿酸血症A、B、C组均较正常血尿酸组显著增高(P<0.01,P=0.01,P<0.01,P<0.01).血浆NT-proBNP在高尿酸血症总组和高尿酸血症C组较正常血尿酸组显著增高(P=0.02,P<0.01).与PCWP<18mm Hg(1 mm Hg=0.133 kPa)组比较,高NT-proBNP和高尿酸血症比率在PCWP≥18 mm Hg、<28mm Hg组和PCWP≥28 mm Hg组均显著增高(P=0.01,P=0.02;P<0.01,P<0.01).偏相关分析表明,血尿酸分别与右房压、右室压、肺动脉压和PCWP相关(r=0.19,P=0.03;r:0.45,P<0.01;r=0.23,P=0.01;r=0.24,P=0.01).多元回归分析表明,血尿酸和血浆NT-proBNP分别与PC:WP独立相关(β=0.24,P=0.01;β=0.47,P<0.01).血浆Hs-CRP以及左室射血分数与血尿酸及PCWP均不相关.结论 心衰患者血尿酸水平与PCWP等有创血液动力学指标独立相关,与血浆NT-proBNP结合可能更有利于心衰患者的临床评价.