血清尿酸水平与阵发性心房纤颤射频消融术后复发的相关性

Correlation of serum uric acid and recurrence of paroxysmal atrial fibrillation after radiofrequency ablation

目的探讨术前血清尿酸水平与阵发性心房纤颤(PAF)患者射频消融术后复发相关性。方法 114例PAF患者按入院时尿酸水平分为高尿酸组(>303μmol/L,57例)和低尿酸组(≤303μmol/L,57例),通过定期随访并根据心电图或24-h动态心电图确诊PAF复发,分析PAF复发与术前血清尿酸水平的相关性。结果平均随访19个月,45例患者复发。高、低尿酸组复发率分别为43.86%和35.09%(P<0.05)。PAF复发患者的尿酸水平高于未复发患者[(337.26±94.21)μmol/L vs.(303.19±77.18)μmol/L](P<0.05)。Cox多因素分析校正性别、体重指数、三酰甘油及高血压后,高尿酸组的复发风险大于低尿酸组(RR=1.005,95%CI为1.001-1.009,P=0.017)。结论术前血清尿酸水平高的PAF患者行射频消融术后有较高的复发率。

Objective To investigate the correlation between preoperative serum uric acid（UA） and the recurrence of paroxysmal atrial fibrillation（PAF） after radiofrequency ablation. Methods On the basis of preoperative serum uric acid（UA） levels, 114 patients with PAF were divided into two groups of A（UA〉303μmol/L,57 cases） and B（UA≤303 μmol/L,57 cases）. The recurrence of PAF was diagnosed by ECG or 24-h dynamic ECG. The correlation between preoperative serum UA and the recurrence of PAF was analyzed. Results The patients were followed up for 19 months in average, which showed that 45 cases had the recurrence of PAF. The recurrence rate of PAF was higher in group A than that in group B（43. 86% vs. 35. 09%） （P〈0. 05）. Serum UA was higher in the cases with recurred PAF than that in those without[（337. 26±94. 21）μmol/L vs. （303. 19±77. 18） μmol/L] （P〈0. 05）. After adjustment for gender, BMI, triglyceride and hypertension, multivariate Cox analysis showed that the risk for the recurrence of PAF was higher in group A than that in group B [RR=1. 005,95%CI（1. 001-1. 009） ,P=0. 017]. Conclusion PAF patients with elevated serum UA before operation is with higher recurrence rate of PAF after radiofrequency ablation.