2型糖尿病患者血清尿酸水平与心房颤动发生率的关系

Relationship between serum uric acid level and atrial fibrillation in patients with type 2 diabetes mellitus

目的探讨2型糖尿病（T2DM）患者血清尿酸（SUA）水平与心房颤动（简称房颤）发生率的关系。方法根据基线SUA水平将270例T2DM患者分为A组（SUA≥300μmol／L）127例和B组（SUA〈300μmol／L）143例，随访5年后再根据随访过程中是否出现房颤将其分为房颤组28例和未发生房颤组242例，并对其临床资料进行比较分析。结果经过5年随访，共28例患者发生房颤，发生率为10．4％。A组中男性、有高血压病病史、慢性肾脏疾病病史、冠心病病史、慢性心力衰竭病史、左心室肥厚及使用利尿剂的患者所占比例均高于B组，差异均有统计学意义（P〈0．05）。与B组相比，A组患者心电图PR间期更长，BMI及血清低密度脂蛋白胆固醇（LDL—C）水平更高，高密度脂蛋白胆固醇（HDL—C）及估算肾小球滤过率（eGFR）更低，差异均有统计学意义（P〈0．05）。房颤组有高血压病病史、左心室肥厚、高尿酸血症、慢性心力衰竭病史及使用利尿剂患者的比例均高于未发生房颤组（P〈0．05）；房颤组患者年龄、收缩压、心电图PR问期及SUA水平均高于未发生房颤组（P〈0．05）。相关性分析结果显示，校正其他影响因素后，SUA水平与房颤发生率呈正相关（OR=2．43，95％CI1．6～3．8，P=0．003）。结论T2DM患者SUA水平与房颤发生率呈明显正相关，提示SUA水平可能为T2DM患者房颤发生的预测提供依据。

Objective To investigate the relationship between serum uric acid （SUA） level and the incidence of atrial fibrillation （AF） in patients with type 2 diabetes mellitus （T2DM）. Methods A total of 270 T2DM patients were divided into group A （SUA≥ 300μmol/L, 127 cases） and group B （ SUA 〈 300μmol/L, 143 cases） according to their SUA levels. After a 5-year follow-up, the patients were divided into AF group （28 cases ） and non-AF group （242 cases ） according to whether there was an incidence of AF. Clinical data were compared and analyzed. Results After a 5-year follow-up,28 patients suffered AF, accounting for 10.4%. Proportions of male patients and patients with history of hypertension, chronic kidney disease, coronary heart disease, chronic heart failure,left ventricular hypertrophy as well as diuretic users were higher in group A than group B （ P 〈 0.05 ）. Compared with group B,patients in group A had longer PR interval in electrocardiogram, higher BMI and serum low density lipoprotein cholesterol （LDL-C） level and lower high density lipoprotein cholesterol（HDL-C） and estimated glomerular filtration rate（ eGFR,P 〈 0.05 ）. Proportions of patients with history of hypertension, left ventricular hypertrophy, hyperuricemia, chronic heart failure and the use of diuretics in AF group were higher than those of non-AF group（P 〈 0.05）. Compared with non-AF group,patients in AF group were older and had higher systolic blood pressure, PR interval in electrocardiogram and SUA （ P 〈 0.05 ）. Correlation analysis showed SUA level was positively related to the incidence of AF after the correction of other factors（ OR = 2. 43,95% CI 1.6-3. 8, P = 0. 003 ）. Conclusion SUA level in T2DM patients is positively correlated with the incidence of AF. SUA level may provide the evidence for the prediction of AF in T2DM patients.