CAJ | 학술논문

目的探讨慢性心力衰竭患者血清尿酸(SUA)水平与心房颤动(房颤)发生的关系及预测价值.方法回顾性分析湖北地区2000年1月1日至2010年5月31日期间心力衰竭住院患者(包括多次入院患者的首次和末次入院)临床资料,所有患者均电话随访.按随访结果将患者分为房颤组和无房颤组、死亡组和存活组.单因素和多因素Cox分析心力衰竭患者房颤的危险因素,多元Logistic回归分析和ROC曲线评价SUA水平对房颤预测的敏感性和特异性.结果入选的16681例患者中,房颤6807例.多因素分析显示SUA水平与房颤密切相关.平均随访5年后,多元Logistic回归分析显示SUA水平(HR 1.084,95％ CI 1.017-1.144,P＜0.001)、利尿剂(HR 1.549,95％ CI 1.246-1.854,P＜0.001)和心功能(NYHA分级,HR 1.237,95％ CI 1.168-1.306,P＜0.001)是房颤发生的独立预测因子.ROC曲线显示SUA增加房颤发生的敏感性和特异性(Wald x2 1494.88,P＜0.001;95％ CI 57.7％-60.0％).结论 SUA水平与心力衰竭患者房颤的发生有密切关系.
목적 탐토만성심력쇠갈환자혈청뇨산(SUA)수평여심방전동(방전)발생적관계급예측개치.방법 회고성분석호북지구2000년1월1일지2010년5월31일기간심력쇠갈주원환자(포괄다차입원환자적수차화말차입원)림상자료,소유환자균전화수방.안수방결과장환자분위방전조화무방전조、사망조화존활조.단인소화다인소Cox분석심력쇠갈환자방전적위험인소,다원Logistic회귀분석화ROC곡선평개SUA수평대방전예측적민감성화특이성.결과 입선적16681례환자중,방전6807례.다인소분석현시SUA수평여방전밀절상관.평균수방5년후,다원Logistic회귀분석현시SUA수평(HR 1.084,95％ CI 1.017-1.144,P＜0.001)、이뇨제(HR 1.549,95％ CI 1.246-1.854,P＜0.001)화심공능(NYHA분급,HR 1.237,95％ CI 1.168-1.306,P＜0.001)시방전발생적독립예측인자.ROC곡선현시SUA증가방전발생적민감성화특이성(Wald x2 1494.88,P＜0.001;95％ CI 57.7％-60.0％).결론 SUA수평여심력쇠갈환자방전적발생유밀절관계.
Objective To investigate the relationship between serum uric acid (SUA) and atrial fibrillation (AF),and examine the prognostic value of SUA levels for AF in patients with chronic heart failure (CHF).Methods Diagnosed with CHF,16681 patients from 12 hospitals in Hubei province were included,from Jan 1st 2000 to May 31st 2010.The first and the last files of those patients who had more than one time hospitalization were investigated.Patients were categorized into AF group and non-AF group,death group and survive group according to the results of patients' medical records and follow-up.Univariate and multivariate Cox proportional hazards analyses were performed to examine the risk of AF.The sensitivity and specificity of SUA in predicting the prognosis were examined by multivariate Cox models and receiver operating characteristic (ROC) curves.Results Before follow-up,6807 patients had AF in the overall population.The results of univariate predictors in overall patients showed that higher SUA level was associated with AF.Over media 5 years follow-up,SUA level ( HR 1.084,95％ CI 1.017-1.144,P＜0.001 ),diuretics ( HR 1.549,95％ CI 1.246-1.854,P＜0.001 ) and NYHA functional class ( HR 1.237,95％ CI 1.168-1.306,P＜0.001 ) was the independent risk factor for AF.ROC curves showed that SUA increase the sensitivity and specificity of predicting models for AF (Waldx2 1494.88,P＜0.001 for AF),with 58.8％ (95％ CI 57.7％～60.0％).Conclusion Higher SUA level are associated with AF in patients with CHF.