摘要
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（HR1．084，95％CI1．017—1．144，P〈0．001）、利尿剂（HR1．549，95％CI1．246—1．854，P〈0．001）和心功能（NYHA分级，HR1．237，95％CI1．168-1．306，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，1494．88，P〈0．001；95％CI57．7％．60．0％）。结论SUA水平与心力衰竭患者房颤的发生有密切关系。
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 1 st 2000 to May 31 - 2010. The first and the last files of those patients who had more than one time hos- pitalization 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 uni- variate 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 inde- pendent risk factor for AF. ROC curves showed that SUA increase the sensitivity and specificity of predicting models for AF （ Wald X2 1494. 88, P〈0. 001 for AF）, with 58. 8% （95% CI 57. 7% - 60. 0% ）. Conclu- sion Higher SUA level are associated with AF in patients with CHF.
出处
《中华心律失常学杂志》
2012年第3期201-205,共5页
Chinese Journal of Cardiac Arrhythmias
关键词
心房颤动
尿酸
慢性心力衰竭
利尿剂
Atrial fibrillation
Uric acid
Chronic heart failure
Diuretics
