CAJ | 학술논문

目的探讨冠心病患者心房颤动与血清尿酸水平的相关性.方法选择住院治疗的冠心病患者247例,所有患者按有无心房颤动及心房颤动持续时间分为单纯冠心病组(90例)、冠心病合并阵发性心房颤动组(85例)和冠心病合并持续性/永久性心房颤动组(72例).记录三组患者年龄、心血管相关病史、尿酸水平、心脏彩超情况及相关用药史,采用Logistic回归分析冠心病患者心房颤动发生的危险因素.结果三组吸烟史、舒张压、体质量指数、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、肌酐、空腹血糖、餐后2h血糖、室间隔厚度、颈动脉内膜-中层厚度及用药史比较差异无统计学意义(P＞0.05).冠心病合并阵发性心房颤动组和冠心病合并持续性/永久性心房颤动组年龄、收缩压、尿酸、左房内径(LAD)、左室舒张末期内径(LVEDD)明显高于单纯冠心病组,左室射血分数则明显低于单纯冠心病组,差异有统计学意义(P＜0.01或＜0.05).Logistic回归分析显示:高尿酸、高龄、LAD和LVEDD增大是冠心病患者心房颤动的独立危险因素,其中尿酸水平与心房颤动相关性最显著(P=0.001,OR=1.061,95％ CI 1.026～1.096).结论高尿酸水平可能是冠心病患者发生心房颤动的危险因素.
목적 탐토관심병환자심방전동여혈청뇨산수평적상관성.방법 선택주원치료적관심병환자247례,소유환자안유무심방전동급심방전동지속시간분위단순관심병조(90례)、관심병합병진발성심방전동조(85례)화관심병합병지속성/영구성심방전동조(72례).기록삼조환자년령、심혈관상관병사、뇨산수평、심장채초정황급상관용약사,채용Logistic회귀분석관심병환자심방전동발생적위험인소.결과 삼조흡연사、서장압、체질량지수、총담고순、고밀도지단백담고순、저밀도지단백담고순、기항、공복혈당、찬후2h혈당、실간격후도、경동맥내막-중층후도급용약사비교차이무통계학의의(P＞0.05).관심병합병진발성심방전동조화관심병합병지속성/영구성심방전동조년령、수축압、뇨산、좌방내경(LAD)、좌실서장말기내경(LVEDD)명현고우단순관심병조,좌실사혈분수칙명현저우단순관심병조,차이유통계학의의(P＜0.01혹＜0.05).Logistic회귀분석현시:고뇨산、고령、LAD화LVEDD증대시관심병환자심방전동적독립위험인소,기중뇨산수평여심방전동상관성최현저(P=0.001,OR=1.061,95％ CI 1.026～1.096).결론 고뇨산수평가능시관심병환자발생심방전동적위험인소.
Objective To investigate the relationship between serum uric acid level and atrial fibrillation in patients with coronary heart disease.Methods Two hundred and forty-seven inpatients with coronary heart disease were selected.All the patients were divided into simple coronary heart disease group (90 cases),coronary heart disease with paroxysmal atrial fibrillation group (85 cases) and coronary heart disease with continuous/permanent atrial fibrillation group (72 cases).The age,history of cardiovascular events,uric acid,echocardiographic characteristics and drug-taking history were carefully recorded.The risk factors of atrial fibrillation in patients with coronary heart disease were analyzed by Logistic regression.Results The level of history of smoking,diastolic blood pressure,body mass index,total cholesterol,high density lipoprotein cholesterol,low density lipoprotein cholesterol,creatinine,fasting plasma glucose,postprandial 2 h plasma glucose,interventricular septal thickness,carotid intima-media thickness and drug-taking history among the 3 groups showed no statistical differences (P ＞ 0.05).The age,systolic blood pressure,uric acid,left atrial diameter (LAD),left ventricular end diastolic diameter (LVEDD) in coronary heart disease with paroxysmal atrial fibrillation group and coronary heart disease with continuous/permanent atrial fibrillation group were significantly higher than those in simple coronary heart disease group,the left ventricular ejection fraction (LVEF) was significantly lower than that in simple coronary heart disease group,and there were statistical differences (P ＜ 0.01 or ＜ 0.05).The result of Logistic regression analysis showed high uric acid,high age,expanded LAD and LVEDD were the independent risk factors of atrial fibrillation in patients with coronary heart disease,and uric acid showed the most significant correlation (P =0.001,OR =1.061,95％ CI 1.026-1.096).Conclusion High serum uric acid level maybe a risk factor of atrial fibrillation in patients with coronary heart disease.