左心房内径、血清UA水平与心房颤动的关系研究

Correlation between left atrial diameter, serum UA level and atrial fibrillation

目的探讨左心房内径(LAD)、尿酸(UA)水平与心房纤颤(房颤,AF)的关系。方法选择2016年1月~6月于深圳市人民医院心内科住院的AF患者239例作为病例组,同期住院的窦性心律且无AF史的患者60例作为对照组,收集病历资料和实验室检查结果,采用超声诊断仪测量左室收缩末期的左心房内径(LAD)、左室舒张末期内径(LVDD)、左室射血分数(LVEF),采用logistic回归分析AF的危险因素。结果病例组患者TC、TG、LEVF均显著低于对照组(P<0.05),病例组UA、LAD均显著高于对照组(P<0.05);Logistic回归分析显示年龄、UA、LAD是房颤发生的危险因素;阵发性AF患者和持续性AF患者UA水平和LAD均显著高于对照组(P<0.05),且持续性AF患者UA水平和LAD高于阵发性AF患者(P<0.05)。结论 LAD与血清UA水平是房颤发生的独立危险因素,并且可能与房颤的进展相关,其机制有待进一步研究确认。

Objective To investigate the correlation between left atrial diameter（LAD）, serum uric acid（UA） level and atrial fibrillation（AF）. Methods 239 patients with AF（case group） and 60 patients without AF（control group） were recruited from Jan 2016 to Jun 2016 in department of cardiology, Shenzhen People＇s Hospital. The medical records and laboratory results were collected. The left ventricular end systolic LAD, left ventricular end diastolic diameter（LVDD） and left ventricular ejection fraction（LVEF） were measured by using an ultrasonic diagnostic instrument. Logistic regression was used to analyze the risk factors of atrial fibrillation. Results The TC, TG and LEVF of the patients in the case group were significantly lower than those in the control group（all P0.05）. The UA and LAD in the case group were significantly higher than those in the control group（all P0.05）. Logistic regression analysis showed that age, UA and LAD were risk factors of atrial fibrillation. The levels of UA and LAD in patients with paroxysmal AF and persistent AF were significantly higher than those in control group（all P0.05）, and the levels of UA and LAD in patients with persistent AF were higher than those with paroxysmal AF（all P0.05）. Conclusion Left atrial diameter and serum uric acid level are independent risk factors of atrial fibrillation, and may be related to the progress of atrial fibrillation, the mechanism needs to be further studied and confirmed.