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心房颤动患者血清尿酸水平的变化及临床意义 被引量:12

Changes of serum uric acid and its clinical significance in patients with atrial fibrillation
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摘要 目的分析心房颤动(AF)患者血清尿酸(UA)水平的变化,并探讨这一变化的临床意义。方法顺序入选共159例AF患者和健康体检者,分为3组:健康对照组,52例,年龄32~66岁,平均(54±1)岁;阵发性AF组(pAF组,AF持续时间<6个月),60例,年龄47~71岁,平均(52±1)岁;慢性AF组(cAF组,AF持续时间>6个月),47例,年龄51~77岁,平均(59±1)岁。样本入选后,详细记录入选者的一般临床资料特征,生物化学技术测定3组入选者的血清UA、高敏C反应蛋白(hs-CRP)水平,经胸多普勒心脏超声测定3组入选者的左心房前后径、左心室舒张末期内径和左心室射血分数,并对入选样本的基本资料和所测临床数据与AF的发生进行单因素和多因素分析。结果 cAF组血清UA水平(476.45±140.87)μmol/L与对照组(293.12±76.77)μmol/L和pAF组(302.38±78.19)μmol/L比较,明显升高(P<0.001)。单因素分析中,年龄(OR:1.116,P<0.001)、hs-CRP(OR:7.603,P<0.001)、UA(OR:1.008,P<0.001)、左心室射血分数(OR:0.864,P<0.001)、左心房前后径(OR:1.365,P=0.001)、高血压(OR:11.407,P<0.001)、服用B受体阻滞剂(OR:8.109,P<0.001)和血管紧张素转换酶抑制剂/血管紧张素Ⅱ受体拮抗剂(OR:4.569,P=0.003)与AF发生有显著性关系。多因素Logistic回归分析显示,仅有hs-CRP与AF的发生独立相关(OR:3.267,P=0.001)。但亚组分析中,左心室射血分数(OR:0.907,P=0.007)和hs-CRP(OR:2.338,P=0.025)是与pAF发生显著相关的独立变量;UA(OR:1.005,P=0.04)和hs-CRP(OR:3.535,P=0.002)是与cAF发生显著相关的独立变量。结论 cAF的发生与患者血清UA水平升高有关,可能是高尿酸血症介导了炎症激活和氧化应激。此结论尚需更大样本的相关性研究来验证。 Objective To investigate the changes of serum uric acid (UA) and its clinical significance in patients with atrial fibrillation (AF). Methods A total of 107 patients with paroxysmal AF[pAF group, n =60, mean age (52 ± 1 ) years] or chronic AF [cAF group, n =47, mean age (59 ±1 ) years] and 52 healthy subjects [ control group, mean age (54 ±1 ) years ] were consecutively enrolled in this study. Serum level of UA and high sensitive C-reactive protein ( hsCRP) were measured. Left atrium diameter ( LAD), left ventricular end-diastolic dimension (LVEDD) and left ventricular ejection fraction (LVEF) were determined by echocardiography. Results Serum level of UA in cAF group [ (476. 45 ± 140. 87) μmol/L] was significantly higher than in control group [ (302. 38 ±78. 19) μmol/L] or pAF group [ (302. 38 ± 78.19)μmol/L](both P 〈 0. 001 ). Multivariable logistic regression analysis showed that hs-CRP was an independent predictor of AF (OR: 3. 267, P=0. 001), and serum UA (OR: 1.005, P=0. O4) and hs-CRP (OR: 3. 535, P= 0. 002) were independent predictors of eAF. Conclusions Increased serum level of UA may be associated with the development of chronic AF.
出处 《中国心血管杂志》 2011年第3期205-208,共4页 Chinese Journal of Cardiovascular Medicine
关键词 心房颤动 尿酸 C反应蛋白 Atrial fibrillation Uric acid C-reactive protein
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参考文献13

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