老年慢性心力衰竭合并心房颤动患者血清尿酸水平的变化  

Changes of Serum Uric Acid Levels in Elderly Patients with Chronic Heart Failure and Atrial Fibrillation

作　　者：汪钰[1] 王学东[1] 刘京锋[1] 郑红晓[1] Wang Yu;Wang Xue-dong;Liu Jing-feng;Zheng Hong-xiao(Coronary Care Unit, Beijing Hepingli Hospital, Beijing 100013, China)

机构地区：[1]北京市和平里医院CCU病房,北京100013

出　　处：《中国医药导刊》2016年第7期657-658,共2页Chinese Journal of Medicinal Guide

摘　　要：目的:探讨老年慢性心力衰竭(CHF)合并心房颤动(AF)患者血清尿酸(UA)水平的变化及临床意义。方法:461例老年CHF患者,平均年龄(75.5±6.2)岁,按AF分为两组:AF组和非AF组。比较两组的临床资料特征、实验室检查和经胸多普勒心脏超声检测结果,并对这些数据与老年CHF患者AF发生间的关系进行单因素和多因素分析。结果:与非AF组相比,AF组的年龄、脑利钠肽(BNP)、血清UA、C型反应性蛋白(CRP)、血肌酐(Cr)、左心房前后径(LAD)、室间隔厚度(IVST)、左心室后壁厚度(LVPWT)、及左心室舒张末期内径(LVEDD)明显升高(P均<0.05),左心室射血分数(LVEF)和肾小球滤过率(e GFR)明显降低(P<0.05)。相关分析显示,年龄、e GFR和LVEF与AF的相关性较强。多因素分析中,血清UA水平是AF发生的独立相关变量。结论:老年CHF合并AF患者血清UA水平升高,后者可能参与了AF的发生。Objective: To investigate the changes of serum uric acid (UA) level and its clinical significance in elderly patients withchronic heart failure (CHF) and atrial fibrillation (AF). Methods: 461 cases of elderly patients with CHF, the average age (75.5±6.2)years old, according to AF divided into two groups: AF group and non AF group. The clinical features, laboratory tests and the results ofDoppler echocardiography were compared between the two groups, and the relationship between these data and the occurrence of AF inelderly patients with CHF were analyzed by single factor and multi factor analysis. Results: Compared with that of non AF group, AFgroup of age, brain natriuretic peptide (BNP), serum uric acid (UA), C reactive protein(CRP), serum creatinine(CR), left atrium beforeand after diameter (LAD), interventricular septal thickness (ivst), left ventricular posterior wall thickness (LVPWT), and left ventriculardiastolic end diameter (LVEDd) increased significantly (P<0.05) and left ventricular ejection ejection fraction (LVEF) and glomerularfiltration rate of EGFR) decreased significantly (P<0.05). Correlation analysis showed that age, eGFR, LVEF and AF are stronglycorrelated. In multivariate analysis, serum UA levels were independent variables associated with AF. Conclusion: Serum UA level inelderly patients with AF complicated with CHF is increased, which may be involved in the occurrence of AF.

关 键 词：老年 慢性心力衰竭 心房颤动 尿酸 

分 类 号：R541.6[医药卫生—心血管疾病] R541.75[医药卫生—内科学]