高血压患者心房颤动与血清尿酸的临床研究

Analysis of uric acid levels and atrial fibrillation in hypertensive patients

目的 探讨高血压患者心房颤动（房颤）与血清尿酸水平的相关性.方法 选择2010年1月至2012年6月本院心内科住院的高血压患者215例,入选患者分为阵发性房颤组（A组,75例）、持续性/永久性房颤组（B组,62例）和单纯高血压组（C组,78例）.记录三组患者年龄、心血管相关病史、尿酸水平、心脏彩超情况及相关用药史,采用logistic回归分析高血压患者房颤发生的危险因素.结果 高血压合并房颤患者的年龄、尿酸水平、左房内径、室间隔厚度均明显高于单纯高血压组,差异有统计学意义（P＜0.05）,高血压合并房颤组的左室射血分数低于单纯高血压组（P＜0.01）.Logistic回归分析显示,高尿酸、左房内径增大、室间隔肥厚是高血压患者房颤的独立危险因素,其中尿酸与房颤相关性最显著（P＜0.001,OR =0.092,95％CI：0.824～1.087）.结论 高尿酸是高血压患者房颤发生的危险因素.

Objective To investigate the association uric acid（UA） levels and atrial fibrillation（AF） in hy- pertensive patients. Methods Our study population consisted of 215 hypertensive patients. 75 patients of them had paroxysmal AF （Group A）, 62 patients of them had persistent or permanent AF （Group B）, and 78 patients without AF were regard as the control group （Group C）. Demographic, clinical, laboratory, and echocardiographic character- istics were carefully recorded. Results After univariate analysis, age, serum UA, left atrial diameter （LAD）, inter- ventricular septum thickness （IVST）, were significantly increased in patients with AF compared with non-AF pa- tients（P〈0.05）, while the left ventricular ejection fraction（LVEF） was much lower in patients with AF than in those without AF（P〈0.01）. After multivariate logistic regression analysis, the independent predictors of AF in hypertensive patients were UA, LAD and IVST. Specially, Serum UA and AF is the most significant correlation （P〈0.01 ,OR= 0.092,95%CI： 0.824-1.087 ）. Conclusion High serum UA levels is an independent risk factor of AF in hyperten- sive patients.