CAJ | 학술논문

目的：分析高血压病心房颤动（ AF）患者血清尿酸（ UA）水平的变化，并探讨其临床意义。方法入选495例高血压病患者，其中合并AF者61例。排除标准包括充血性心力衰竭、冠心病、瓣膜性心脏病、心肌病、先天性心脏病、糖尿病、肾脏功能衰竭、炎症以及正在应用影响UA代谢（利尿剂除外）药物的患者。记录入选者的一般临床资料特征、实验室检查和经胸多普勒心脏超声检测结果，并对这些数据与AF发生之间的关系进行单因素和多因素分析。结果年龄、高血压病年限、血清UA、血肌酐、左心房前后径、左心室后壁厚度以及室间隔厚度在AF患者明显高于非AF患者（ P＜0.05或P＜0.01），AF患者的左心室射血分数和肾小球滤过率明显低于非AF患者（ P＜0.05）。多因素分析结果中，仅UA成为与AF发生有关的独立变量（OR：1.014，95％ CI：1.009～1.019，P＜0.001）。结论高血压病患者AF的出现与血清UA水平增加有关，机制可能是血清UA水平升高介导了炎症激活和氧化应激程度增强。
목적：분석고혈압병심방전동（ AF）환자혈청뇨산（ UA）수평적변화，병탐토기림상의의。방법입선495례고혈압병환자，기중합병AF자61례。배제표준포괄충혈성심력쇠갈、관심병、판막성심장병、심기병、선천성심장병、당뇨병、신장공능쇠갈、염증이급정재응용영향UA대사（이뇨제제외）약물적환자。기록입선자적일반림상자료특정、실험실검사화경흉다보륵심장초성검측결과，병대저사수거여AF발생지간적관계진행단인소화다인소분석。결과년령、고혈압병년한、혈청UA、혈기항、좌심방전후경、좌심실후벽후도이급실간격후도재AF환자명현고우비AF환자（ P＜0.05혹P＜0.01），AF환자적좌심실사혈분수화신소구려과솔명현저우비AF환자（ P＜0.05）。다인소분석결과중，부UA성위여AF발생유관적독립변량（OR：1.014，95％ CI：1.009～1.019，P＜0.001）。결론고혈압병환자AF적출현여혈청UA수평증가유관，궤제가능시혈청UA수평승고개도료염증격활화양화응격정도증강。
Objective To study the relationship between the development of atrial fibrillation ( AF) and the level of serum uric acid in hypertensive patients .Methods 495 hypertensive patients were enrolled .Of these patients,there were 61 with AF.Subjects with congestive heart failure ,coronary artery disease ,valvular heart disease , congenital heart disease,cardiomyopathy,diabetes,renal failure,inflammatory conditions,and those who were taking drugs that affect UA metabolism were excluded .Clinical characteristics and the data of laboratory as well as echocardiographic of all enrolled patients were carefully recorded .Results The age,duration of hypertension ,serum UA,serum creatinine , left atrial diameter ( LAD ) , interventricular septum thickness ( IVST ) , and left ventricular posterior wall thickness ( LVPWT) were significantly higher in patients with AF than in those without AF ( P<0.05 or P<0.01),the left ventricular ejection fraction(LVEF)and the estimated glomerular filtration(eGFR)were lower in patients with AF than in those without AF ( P<0.05 ) .Multivariable logistic regression analysis showed that serum UA was independent predictors of AF ( OR:1.014 , 95% CI:1.009-1.019 , P <0.001 ) .Conclusion Increased serum level of UA is associated with the development of AF in hypertensive patients ,and the mechanism may be that hyperuricaemia is involved in inflammation activation and oxidative stress .