2型糖尿病患者血清尿酸水平与心房颤动发生率的关系

摘要

Objective To investigate the relationship between serum uric acid(SUA) level and the incidence of atrial fibrillation(AF) in patients with type 2 diabetes mellitus(T2DM).Methods A total of 270 T2DM patients were divided into group A(SUA≥300μmol/L,127 cases) and group B(SUA<300μmol/L,143 cases) according to their SUA levels.After a 5-year follow-up,the patients were divided into AF group(28 cases) and non-AF group(242 cases) according to whether there was an incidence of AF.Clinical data were compared and analyzed.Results After a 5-year follow-up,28 patients suffered AF,accounting for 10.4%.Proportions of male patients and patients with history of hypertension,chronic kidney disease,coronary heart disease,chronic heart failure,left ventricular hypertrophy as well as diuretic users were higher in group A than group B(P<0.05).Compared with group B,patients in group A had longer PR interval in electrocardiogram,higher BMI and serum low density lipoprotein cholesterol(LDL-C) level and lower high density lipoprotein cholesterol(HDL-C) and estimated glomerular filtration rate(eGFR,P<0.05).Proportions of patients with history of hypertension,left ventricular hypertrophy,hyperuricemia,chronic heart failure and the use of diuretics in AF group were higher than those of non-AF group(P<0.05).Compared with non-AF group,patients in AF group were older and had higher systolic blood pressure,PR interval in electrocardiogram and SUA(P<0.05).Correlation analysis showed SUA level was positively related to the incidence of AF after the correction of other factors(OR=2.43,95%CI 1.6-3.8,P=0.003).Conclusion SUA level in T2DM patients is positively correlated with the incidence of AF.SUA level may provide the evidence for the prediction of AF in T2DM patients.%目的 探讨2型糖尿病(T2DM)患者血清尿酸(SUA)水平与心房颤动(简称房颤)发生率的关系.方法 根据基线SUA水平将270例T2DM患者分为A组(SUA≥300μmol/L)127例和B组(SUA<300μmol/L)143例,随访5年后再根据随访过程中是否出现房颤将其分为房颤组28例和未发生房颤组242例,并对其临床资料进行比较分析.结果 经过5年随访,共28例患者发生房颤,发生率为10.4%.A组中男性、有高血压病病史、慢性肾脏疾病病史、冠心病病史、慢性心力衰竭病史、左心室肥厚及使用利尿剂的患者所占比例均高于B组,差异均有统计学意义(P<0.05).与B组相比,A组患者心电图PR间期更长,BMI及血清低密度脂蛋白胆固醇(LDL-C)水平更高,高密度脂蛋白胆固醇(HDL-C)及估算肾小球滤过率(eGFR)更低,差异均有统计学意义(P<0.05).房颤组有高血压病病史、左心室肥厚、高尿酸血症、慢性心力衰竭病史及使用利尿剂患者的比例均高于未发生房颤组(P<0.05);房颤组患者年龄、收缩压、心电图PR间期及SUA水平均高于未发生房颤组(P<0.05).相关性分析结果显示,校正其他影响因素后,SUA水平与房颤发生率呈正相关(OR=2.43,95%CI 1.6~3.8,P=0.003).结论 T2DM患者SUA水平与房颤发生率呈明显正相关,提示SUA水平可能为T2DM患者房颤发生的预测提供依据.