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尿酸与非瓣膜性心房颤动患者左心房血栓形成的相关性 预览

Correlation of uric acid and left atrial thrombus in patients with non-valvular atrial fibrillation
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摘要 目的探讨尿酸与非瓣膜性心房颤动(non-valvular atrial fibrillation,NVAF)患者左心房血栓形成的相关性。方法选取2012年1月至2017年1月于重庆市红十字会医院收治的怀疑存在左心房血栓的NVAF患者390例作为研究对象,根据食管心脏超声检查结果,分为血栓组(45例)和非血栓组(345例)。记录患者一般临床资料及相关实验室检查等指标,分析左心房血栓形成的独立危险因素,绘制受试者工作特征曲线(receiver operating characteristic curve,ROC)分析尿酸对NVAF患者左心房血栓形成的预测价值。结果血栓组患者血清尿酸浓度明显高于非血栓组患者,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,充血性心力衰竭、心房颤动病程、CHADS2评分、CHA2DS2-VASc评分及尿酸浓度是患者血栓形成的独立危险因素。相关性分析结果显示,血栓组患者尿酸浓度与CHADS2评分、CHA2DS2-VASc评分呈正相关(CHADS2评分:r=0.618,P=0.036;CHA2DS2-VASc评分:r=0.646,P=0.032)。ROC分析结果显示,血清尿酸浓度曲线下面积(ACU)为0.895(95%CI:0.825~0.966),其最佳工作点为459.8μmol/L,此时预测NVAF患者左心房血栓形成的敏感性和特异性分别为80.0%和85.0%。结论血清尿酸浓度在NVAF并发左心房血栓形成的患者中明显升高,其可作为左心房血栓形成的独立危险因素,对于评估左心房血栓形成,具有一定的临床预测价值。 Abstract:Objectives To investigate the correlation of uric acid and left atrial thrombus in patients with non-valvular atrial fibrillation(NVAF).Methods Totally 390 patients with NVAF suspected with left atrial thrombus were enrolled in Jiangbei District People′s Hospital of Chongqing from January 2012 to January 2017.According to the results of transesophageal echocardiography examination,these patients were divided into the thrombus group(45 cases)and non-thrombus group(345 cases).The baseline clinical characteristics and related laboratory examination of the patients were recorded,the independent risk factors of left atrial thrombosis were analyzed,and the predictive value of uric acid in left atrial thrombosis in NVAF patients were assessed by receiver operating characteristic curve(ROC).Results Serum concentration of uric acid was significantly higher in thrombus group than that in non-thrombus group group(P<0.05).Multivariate Logistic regression analysis showed that congestive heart failure,atrial fibrillation course,CHADS2 score,CHA2DS2-VASc score and uric acid were independent risk factors for thrombosis in patients with NVAF.Correlation analsis showed that serum concentration of uric acid,CHADS2 score and CHA2DS2-VASc score in thrombus group were positively correlated(CHADS2 score:r=0.618,P=0.036;CHA2DS2-VASc score:r=0.646,P=0.032).ROC analysis showed that the area under curve(AUC)of serum concentration of uric acid was 0.895(95%CI:0.825-0.966),and optimal operating point(OOP)was 459.8μmol/L,which had 80.0%sensiticity and 85.0%specificity in assessing the left atrial thrombosis of NVAF patients.Conclusions Serum concentration of uric acid significantly elevated in patients with NVAF complicated with left atrial thrombosis,which could be an independent risk factor for left atrial thrombosis and had important clinical predictive value for assessing left atrial thrombosis.
作者 刘俊 周平 LIU Jun;ZHOU Ping(Department of Cardiology,Jiangbei District People′ s Hospital of Chongqing,the Red Cross Hospital ofChongqing,Chongqing 400020,China;Department of Cardiology,The First People′s Hospital of ChongqingLiang Jiang New Area,Chongqing 401121,China)
出处 《岭南心血管病杂志》 2019年第1期72-75,共4页 South China Journal of Cardiovascular Diseases
关键词 心房颤动 尿酸 左心房血栓 CHADS2评分 CHA2DS2-VASc评分 atrial fibrillation uric acid left atrial thrombosis CHADS2 score,CHA2DS2-VASc score
作者简介 刘俊(1983-),女,主治医师,研究方向为心房颤动的诊治;通信作者:周平,E-mail:zhoupcq01@163.com.
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