摘要
目的研究术前血尿酸水平与非体外循环冠状动脉旁路移植术(OPCABG)患者术后心房颤动发生率的关系。方法采用回顾性分析方法,研究对象为2019年6月至2020年6月运城市中心医院收治的290例OPCABG患者,参考术前1 d血尿酸水平划分为尿酸正常组(239例)与高尿酸组(51例,女性>350μmol/L,男性>420μmol/L);比较2组患者术后心房颤动发生率、术后24 h血管活性药物使用情况、术后24 h血肌酐、机械通气时间、气管切开率、二次气管插管率、连续性肾脏替代治疗率、二次开胸探查率、心肺复苏率、术后置入主动脉内球囊反搏率、术后左心室射血分数、住重症监护室时间、术后住院时间及病死率,并通过Logistic回归方法分析术前血尿酸与术后心房颤动发生关系。结果高尿酸组术后心房颤动发生率、术后24 h血肌酐水平、置入主动脉内球囊反搏率分别为39.22%、(101.97±12.85)μmol/L、13.73%,明显高于尿酸正常组[24.69%、(86.82±9.93)μmol/L、5.44%],术后左心室射血分数为(41.83±3.95)%,明显低于尿酸正常组[(48.67±4.82)%],差异均有统计学意义(P<0.05)。多因素分析显示,OPCABG患者术后心房颤动发生的独立相关因素有术前血尿酸水平、术后24 h血肌酐水平、术后左心室射血分数、术后置入主动脉内球囊反搏率。结论OPCABG患者术后心房颤动与术前血尿酸水平密切相关,心房颤动发生率随血尿酸水平上升而上升。
Objective To study the relationship between the level of serum uric acid(BUA)before surgery and the incidence of atrial fibrillation(AF)after off-pump coronary artery bypass grafting(OPCABG).Methods A retrospective analysis was performed on 290 OPCABG patients admitted to Yuncheng Central Hospital from June 2019 to June 2020,who were divided into normal uric acid group(239 cases)and high uric acid group(51 cases,female>350μmol/L and male BBB>0μmol/L)according to the level of BUA 1 day before surgery.Compared two groups of postoperative AF incidence,24 h after vascular active drug usage,serum creatinine and 24 h after surgery,the rate of tracheotomy,mechanical ventilation time and secondary endotracheal intubation rate,continuous renal replacement therapy,second rate,rate of cardiopulmonary resuscitation(CPR)with open thoracic exploration,in rate of intraaortic balloon counterpulsation after operation,postoperative left ventricular ejection fraction,live in the intensive care unit time,postoperative hospital stay and mortality,and through the Logistic regression method to analyze BUA preoperative and postoperative AF.Results The incidence of postoperative AF in the high uric acid group,the level of blood creatinine at 24 hours postoperatively,and the rate of intra-aortic balloon counterpulsation were 39.22%,(101.97±12.85)μmol/L,and 13.73%,respectively,which were significantly higher than those in the normal uric acid group[24.69%,(86.82±9.93)μmol/L,5.44%],the postoperative left ventricular ejection fraction was(41.83±3.95)%,which was significantly lower than the normal uric acid group[(48.67±4.82)%],the differences were statistically significant(P<0.05).Univariate analysis showed that the preoperative BUA level of OPCAB patients was closely related to gender,postoperative AF,postoperative 24 h serum creatinine level,postoperative intra-aortic balloon counterpulsation,and postoperative left ventricular ejection fraction.Multivariate analysis showed that the independent related factors for the increase of preoperative BUA level were postoperative AF,postoperative 24 h serum creatinine level,postoperative intra-aortic balloon counterpulsation,and postoperative left ventricular ejection fraction.Conclusion Postoperative AF is closely related to preoperative BUA level in OPCABG patients,and the incidence of AF increases with the increase of BUA level.
作者
张振忠
胡艳娜
姚鹏
ZHANG Zhen-zhong;HU Yan-na;YAO Peng(Department of Cardiovascular Surgery,Yuncheng Central Hospital,Yuncheng Shanxi 044000,China)
出处
《临床和实验医学杂志》
2021年第20期2189-2192,共4页
Journal of Clinical and Experimental Medicine
基金
国家自然科学基金项目(编号:81760036)。
