择期心脏外科手术患者相关危险因素之一——术后高尿酸血症

贵州医科大学  麻醉学与心脏电生理课题组

翻译：黄祥

编辑：宋雨婷

审校：曹莹

目的

高尿酸血症是众所周知的心血管疾病危险因素。本研究旨在探讨择期心脏外科手术患者术后高尿酸血症与不良预后的关联性。  

方法

本试验为一项回顾性研究。将227名择期心脏手术患者分为两组：第一组由42名术后高尿酸血症患者（平均年龄65.14±8.9岁）组成，第二组由185名无术后高尿酸血症的患者（平均年龄 62.67 ± 7.45 岁）组成。机械通气时间（小时）和重症监护病房时间（天）作为主要结局指标，次要结局指标包括术后并发症。评估风险的EuroSCORE值在组间或合并症之间没有差异。最常见的并发症是高血压，占所有患者的66%（术后高尿酸血症患者为69%，无术后高尿酸血症患者为63.7%）。   

结果

与无术后高尿酸血症的患者相比，术后高尿酸血症患者在重症监护病房的治疗时间延长 (P =0.03)，机械通气时间延长 (P < 0.01)，并且以下术后并发症的发生率显著升高：循环不稳定和/或低心输出量综合征 (LCOS)（χ2 = 4486，P < 0.01）、肾功能衰竭和/或连续静脉血液透析（CVVHDF's）（χ2 = 10,241，P < 0.001）和死亡率（χ2 = 5.22，P < 0.01)。 

结论

与择期心脏手术术后无高尿酸血症的患者相比，术后高尿酸血症患者在重症监护病房的治疗时间延长，机械辅助通气时间延长，术后循环不稳定、肾功能衰竭和死亡的发生率更高。 

原始文献来源：

Raos, D.; Prkaˇcin, I.; Delali´c,Ð.; Bulum, T.; Lovri´c Benˇci´c, M.; Jug,J. Postoperative Hyperuricemia—A Risk Factor in Elective Cardiosurgical Patients. Metabolites 2023, 13, 590. 

英文原文

Postoperative Hyperuricemia—A Risk Factor in Elective Cardiosurgical Patients

Objective: Hyperuricemia is a well-known cardiovascular risk factor. The aim of our study was to investigate the connection between postoperative hyperuricemia and poor outcomes after elective cardiac surgery compared to patients without postoperative hyperuricemia.

Methods: In this retrospective study, a total of 227 patients after elective cardiac surgery were divided into two groups: 42 patients with postoperative hyperuricemia (mean age 65.14 ± 8.9 years) and a second group of 185 patients without it (mean age 62.67 ± 7.45 years). The time spent on mechanical ventilation (hours) and in the intensive care unit (days) were taken as the primary outcome measures while the secondary measure comprised postoperative complications. The preoperative patient characteristics were similar. Most of the patients were men. The EuroSCORE value of assessing the risk was not different between the groups nor the comorbidities. Among the most common comorbidities was hypertension, seen in 66% of all patients (69% in patients with postoperative hyperuricemia and 63.7% in those without it).

Results: A group of patients with postoperative hyperuricemia had a prolonged time of treatment in the intensive care unit (p = 0.03), as well as a prolonged duration of mechanical ventilation (p < 0.01) and a significantly higher incidence of the following postoperative complications: circulatory instability and/or low cardiac output syndrome (LCOS) (χ2 = 4486, p < 0.01), renal failure and/or continuous venovenous hemodiafiltration (CVVHDF’s) (χ2 = 10,241, p < 0.001), and mortality (χ2 = 5.22, p < 0.01).

Conclusions: Compared to patients without postoperative hyperuricemia, elective cardiac patients with postoperative hyperuricemia have prolonged postoperative treatment in intensive care units, extended durations of mechanically assisted ventilation, and a higher incidence of postoperative circulatory instability, renal failure, and death.

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