甲亢患者血清尿酸水平与发生房颤的相关性分析

Association between serum uric level and atrial fibrillation in patients with hyperthyroidism

目的分析血清尿酸水平与甲状腺功能亢进症患者心房颤动的关系。方法回顾性收集2013年10月-2015年10月于该院就诊的227例甲亢患者临床资料,根据是否合并房颤,分为甲亢伴房颤组(n=49)和甲亢无房颤组(n=178),排外除甲亢以外其他疾病导致的房颤及其他可以引起尿酸水平变化的因素。记录入选患者的一般资料、实验室检查及心脏彩超结果,并对这些数据与房颤发生之间的关系进行单因素和多因素Logistic回归分析。结果甲亢伴房颤组的年龄、甲亢病程、尿素氮、肌酐、尿酸、球蛋白、左心房前后径及左心室舒张末期内径均高于甲亢无房颤组(P<0.05),甲亢伴房颤组的肾小球滤过率、总胆固醇、高密度脂蛋白、低密度脂蛋白、白蛋白及左室射血分数低于甲亢无房颤组(P<0.05)。通过多因素Logistic回归分析显示年龄(^OR:1.097,95%CI:1.036,1.160)、尿酸(^OR:1.009,95%CI:1.002,1.016)、左心房前后径(^OR:1.294,95%CI:1.134,1.476)及左室射血分数(^OR:0.902,95%CI:0.814,1.000)是甲亢患者房颤发生的独立相关因素。结论尿酸水平是甲亢患者房颤发生的危险因素,年龄、左心房前后径和左室射血分数也与甲亢患者房颤发生存在独立相关性。

Objective To investigate the association between atrial fibrillation（AF） and serum uric acid（SUA） level in patients with hyperthyroidism. Methods 227 hospitalization patients with hyperthyroidism treated in our hospital from October 2013 to October 2015, were divided into hyperthyroidism with AF group（n = 49）and hyperthyroidism without AF group（n = 178） according to whether had AF or not. Clinical characteristics,laboratory data and characteristics of all patients were carefully recorded. The association between AF and those clinical data of the two groups were analyzed by univariate and multivariate logistic regression analysis.Results The age, duration of hyperthyroidism, blood urea nitrogen, serum creatinine, SUA, globulin, left atrial diameter（LAD）, left ventricular end-diastolic dimension（LVEDD） were significantly higher in hyperthyroidism with AF group than those in hyperthyroidism without AF group（P 0.05）. The estimated glomerular filtration rate（e GFR）, total cholesterol, high-density lipoprotein, low-density lipoprotein, albumin, left ventricular ejection fraction（LVEF） were lower in hyperthyroidism with AF group than those in hyperthyroidism without AF group（P 0.05）. Multivariate logistic regression analysis showed that only age（^OR： 1.097, 95% CI： 1.036, 1.160）, SUA（^OR： 1.009, 95% CI： 1.002, 1.016）, LAD（^OR： 1.294, 95% CI： 1.134, 1.476）, LVEF（^OR： 0.902, 95% CI：0.814, 1.000） were independently associated with AF in patients with hyperthyroidism. Conclusions SUA maybe a risk factor of AF in patients with hyperthyroidism. And age, LAD, LVEF are independently associated with AF in patients with hyperthyroidism.