尿酸/高密度脂蛋白胆固醇比值与房颤射频消融术后复发的相关性  

Correlation of uric acid to HDL-C ratio with recurrence after radiofrequency ablation of atrial fibrillation

作　　者：王保龙 王昌会[1] Wang Baolong;Wang Changhui(Dept of Cardiology,The First Affiliated Hospital of Anhui Medical University,Hefei 230022)

机构地区：[1]安徽医科大学第一附属医院心血管内科,合肥230022

出　　处：《安徽医科大学学报》2024年第7期1269-1274,共6页Acta Universitatis Medicinalis Anhui

基　　金：国家自然科学基金区域联合基金重点项目(编号:U22A20154);安徽省高等学校自然科学研究项目(编号:2023AH053295)。

摘　　要：目的探讨尿酸/高密度脂蛋白胆固醇比值(UHR)与非瓣膜性房颤患者射频消融术后晚期复发的相关性。方法选取2018年1月—2022年1月首次接受经导管心脏射频消融治疗的586例非瓣膜性房颤患者的临床资料,根据UHR值三分位法,把研究人群分为低值组(n=196)、中值组(n=195)和高值组(n=195),房颤晚期复发为随访终点事件。比较三组间一般资料和实验室检查指标,采用Kaplan-Meier法估计并绘制生存曲线,采用多因素COX回归分析评价UHR与消融术后房颤复发的独立相关性并进行亚组分析。结果随访时间内共记录了182例(31.1%)房颤患者的晚期复发。Kaplan-Meier生存曲线显示UHR低值组、中值组、高值组三组间窦性心律维持率逐渐降低(Log-rank检验,P<0.001)。在完全校正模型中,与低值组的患者比较,中值组和高值组消融术后房颤晚期复发的HR(95%CI,P)分别为1.56(0.99~2.42,P=0.057)和2.03(1.28~3.23,P=0.003)。亚组分析显示,在年龄≥60岁、体质量指数≥25 kg/m^(2)、持续性房颤、左心房内径≥4.3 cm、高血压病、无心力衰竭及无高脂血症的患者中,观察到UHR与消融术后房颤晚期复发的相关性显著。结论非瓣膜性房颤患者较高的UHR值与射频消融术后房颤晚期复发风险增加独立相关。Objective To investigate the correlation between uric acid to high-density lipoprotein cholesterol ratio(UHR)and late recurrence after radiofrequency ablation in patients with non-valvular atrial fibrillation(AF).Methods The clinical data of 586 patients with non-valvular AF underwent catheter radiofrequency ablation for the first time from January 2018 to January 2022 were selected,and the study population was classified into a low-value group(n=196),a medium-value group(n=195),and a high-value group(n=195)according to the trichotomous method based on the UHR value,with late recurrence of AF as the endpoint event of the follow up.The general data and laboratory indexes were compared among the three groups.Survival curves were estimated and plotted using the Kaplan-Meier method.Multivariate COX regression analysis was used to evaluate the independent correlation between UHR and recurrence of AF after ablation,followed by subgroup analysis.Results Late recurrence of AF was documented in a total of 182(31.1%)patients during the follow-up time.The Kaplan-Meier survival curve showed a gradual decrease in the maintenance rate of sinus rhythm across the UHR low-value group,middle-value group,and high-value group(Log-rank test,P<0.001).In the fully-adjusted model,compared with the patients in the low-value group,the medium-value and high-value groups had a post-ablation late recurrence of AF with HR(95%CI,P)were 1.56(0.99-2.42,P=0.057)and 2.03(1.28-3.23,P=0.003),respectively.Subgroup analysis showed that the association between UHR and late recurrence of AF after ablation was remarkable among patients with aged≥60 years,BMI≥25 kg/m^(2),persistent AF,LAD≥4.3 cm,hypertension,without heart failure and without hyperlipidemia.Conclusion Higher UHR values in patients with non-valvular AF are independently associated with an increased risk of late recurrence of AF after radiofrequency ablation procedures.

关 键 词：尿酸 高密度脂蛋白胆固醇 心房颤动 射频消融术 晚期复发 

分 类 号：R541.7[医药卫生—心血管疾病]