扩张型心肌病患者血尿酸水平与心房颤动的关系

目的 探讨扩张型心肌病(DCM)患者血尿酸水平与心房颤动(房颤)发生的关系以及临床意义.方法 回顾性分析2010年1月至2011年12月在我院住院治疗的DCM患者的临床资料,比较房颤组(48例)与非房颤组(129例)年龄、心功能分级、血尿酸水平、左心房内径、左心室舒张末内径、左心室射血分数、室间隔厚度、左心室后壁厚度的差异.按尿酸水平分为升高组(88例)与正常组(89例)后比较房颤发生率,并分析尿酸水平对于房颤发生的影响.结果 与非房颤组比较,房颤组患者年龄较大(64±13)岁比(59±15)岁,P＜0.05],血尿酸水平明显升高(491±135)μmol/L比(424±121) μmol/L,P＜0.01],左心房内径明显增大 (48 ±8)mm比(43 ±5)mm,P＜0.01]；血尿酸升高组患者房颤的发生率较正常组高34.1％ (30/88)比20.2％ (18/89),P＜0.05]；血尿酸水平(OR:1.003,95％ CI:1.000 ～1.006,P＜0.05)和左心房内径(OR:1.147,95％ CI:1.076～1.224,P＜0.01)是DCM患者发生房颤的独立危险因素.结论 血尿酸水平是DCM患者发生房颤的独立危险因素,可以作为DCM患者发生房颤的预测指标.

Correlation between uric acid and atrial fibrillation in patients with dilated cardiomyopathy

Objective To investigate the association between uric acid and atrial fibrillation in patients with dilated cardiomyopathy. Methods Patients with dilated cardiomyopathy were screened. Age, serum uric acid, NYHA classes, left atrial dimension （LAD） ,left ventricular end-diastolic dimension （LVEDD）, left ventricular ejection fraction （LVEF）, interventricular septal thickness （IVST） and left ventricular posterior wall thickness （LVP- WT） were compared between the dilated cardiomyopathy patients with atrial fibrillation and those without atrial fibrillation. The incidence of atrial fibrillation was compared between elevated uric acid level patients and normal ones. The effect of serum uric acid on the initiation and perpetuation of atrial fibrillation was also analyzed. Results After univariate analysis, age （64 ± 13 ）years vs （59 ± 15 ）years, P 〈 0.05 ], uric acid （491± 135 ） μmol/L vs （424 ± 121 ）μmol/L, P 〈 0.01 ], LAD （48 ± 8 ） mm vs （43 ± 5 ） mm, P 〈 0.01 ] were significantly increased in patients with atrial fibrillation compared with non-atrial fibrillation patients. There was a higher incidence of atrial fibrillation in the elevated uric acid group than in the normal uric acid group34.1% （30/88）vs 20.2% （18/89） ,P 〈0.05]. After multivariate logistic regression analysis, the independent predictors of atrial fibrillation were uric acid （ OR： 1. 003,95% CI： 1. 000-1. 006, P 〈 0.05 ） and LAD （ OR： 1. 147,95% CI： 1. 076-1. 224, P 〈 0.01 ）. Conclusion There is an independent association between elevated serum uric acid levels and atrial fibrillation in patients with DCM, and the uric acid levels might be a useful predictor of atrial fibrillation.