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[目的]探讨老年射血分数保留心力衰竭(HFPEF)患者血尿酸(BUA)、同型半胱氨酸(Hcy)水平与病情重程度及预后的关系.[方法]选取本院收治的 203 例老年 HFPEF患者(观察组),根据 NYHA心功能分级将其分为心功能Ⅱ级组(n＝72),心功能Ⅲ级组(n＝75),心功能Ⅳ级组(n＝56).同时选取同期 50例健康志愿者作为对照组.比较各组 BUA、Hcy、N末端 B型利尿钠肽前体(NTproBNP)、左室射血分数(LVEF)水平.随访 1 年,根据预后情况分为预后不良组和预后良好组,比较两组患者心功能分级情况, BUA、Hcy和 NTproBNP水平.采用 ROC曲线分析 BUA和 Hcy预测患者预后的价值.[结果]观察组血清BUA、Hcy、NTproBNP水平显著高于对照组,差异有统计学意义(P ＜0.05);LVEF水平比较,差异无统计学意义(P ＞0.05).心功能Ⅳ级组血清 BUA、Hcy、NTproBNP水平最高,心功能Ⅲ级组次之,心功能Ⅱ级最低,差异均有统计学意义(P ＜0.05).Pearson分析显示,血清 BUA、Hcy水平与 NTproBNP均呈正相关(r分别为0.784、0.732,均P ＜0.05).预后良好组患者入院时心功能分级(NYHA Ⅲ～Ⅳ级)比例、血清BUA、Hcy、NTproBNP水平均低于预后不良组,差异均有统计学意义(P ＜0.05).[结论]HFPEF患者血清BUA、Hcy水平显著上升,与左室功能呈正相关,对 HFPEF的诊断、严重程度、预后具有一定的参考价值.“,”[Objective]To explore the relationship between the levels of serum uric acid (BUA)and homocysteine (Hcy)and the severity of the disease and prognosis in the elderly patients with heart failure (HFPEF) preserved by ejection fraction.[Methods]A total of 203 elderly HFPEF patients (observation group)admitted to our hospital from March 2016 to September 2017 were divided into two groups according to NYHA cardiac function grade Ⅱ(n ＝72),cardiac function grade Ⅲ(n ＝75 )and cardiac function grade Ⅳ(n ＝56). Meanwhile,50 healthy volunteers in the same period were selected as the control group.BUA,Hcy,NTproBNP and LVEF were compared in each group.One year followup,according to the prognosis,patients were divided into poor prognosis group and good prognosis group.ROC curve was used to analyze the prognostic value of BUA and Hcy.[Results]The levels of BUA,Hcy and NTproBNP in the observation group were significantly higher than those in the control group,the difference was statistically significant (P ＜0.05);compared with levf,the difference was not statistically significant (P ＞0.05).The levels of BUA,Hcy and NTproBNP were the highest in grade Ⅳ group,the second in grade Ⅲ group,and the lowest in grade ⅡGroup (P ＜0.05).Pearson analysis showed that serum BUA and Hcy levels were positively correlated with NTproBNP (r＝0.784 and 0.732,respectively,P ＜0.05).203 patients were hospitalized or died due to adverse mace events (poor prognosis group),including 27 cases of central colic,19 cases of acute myocardial infarction,13 cases of serious arrhythmia and 5 cases of death.The other 139 patients were included in the good prognosis group.The proportion of NYHAⅢ～Ⅳ,serum BUA,Hcy and NTproBNP water in patients with good prognosis were lower than those in patients with poor prognosis (P＜0.05).[Conclusion]The level of se rum BUA and Hcy in HFPEF patients increases significantly,which is positively correlated with left ventricular function,and has a certain reference value for the diagnosis,severity and prognosis of HFPEF.