非瓣膜性心房颤动患者血尿酸、红细胞比容水平与缺血性脑卒中的相关性分析

马春鸽, 梁二鹏, 王现青, 等. 非瓣膜性心房颤动患者血尿酸、红细胞比容水平与缺血性脑卒中的相关性分析[J]. 临床心血管病杂志, 2021, 37(6): 547-552. doi: 10.13201/j.issn.1001-1439.2021.06.011
引用本文: 马春鸽, 梁二鹏, 王现青, 等. 非瓣膜性心房颤动患者血尿酸、红细胞比容水平与缺血性脑卒中的相关性分析[J]. 临床心血管病杂志, 2021, 37(6): 547-552. doi: 10.13201/j.issn.1001-1439.2021.06.011
MA Chunge, LIANG Erpeng, WANG Xianqing, et al. Correlation between blood uric acid,hematocrit levels,and ischemic stroke in patients with non-valvular atrial fibrillation[J]. J Clin Cardiol, 2021, 37(6): 547-552. doi: 10.13201/j.issn.1001-1439.2021.06.011
Citation: MA Chunge, LIANG Erpeng, WANG Xianqing, et al. Correlation between blood uric acid,hematocrit levels,and ischemic stroke in patients with non-valvular atrial fibrillation[J]. J Clin Cardiol, 2021, 37(6): 547-552. doi: 10.13201/j.issn.1001-1439.2021.06.011

非瓣膜性心房颤动患者血尿酸、红细胞比容水平与缺血性脑卒中的相关性分析

  • 基金项目:

    国家自然科学基金面上项目(No:81970285)

详细信息
    通讯作者: 姚焰,E-mail:ianyao@263.net.cn
  • 中图分类号: R541.7

Correlation between blood uric acid,hematocrit levels,and ischemic stroke in patients with non-valvular atrial fibrillation

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  • 目的:探讨血尿酸(SUA)和红细胞比容(Hct)水平与非瓣膜性心房颤动(房颤)患者脑卒中的关系。方法:连续入选2018年1月-2019年6月于华中阜外医院拟行心脏射频消融术并符合标准的845例非瓣膜性房颤患者,记录所有患者病史资料、SUA以及Hct等化验指标和经胸超声心动图参数,并进行CHA2DS2-VASc评分。对Hct水平进行分类:高Hct(男≥49%,女≥44%),正常Hct(男42%~49%,女37%~44%),低Hct(男≤42%,女≤37%)。依据既往病史及头颅CT或MRI检查,将入选患者分为卒中组(171例)和非卒中组(674例)。分析房颤脑卒中与各潜在危险因素之间的关系。结果:卒中组年龄、BMI、血肌酐、肾小球滤过率、D-二聚体、B型利钠肽前体、左心房内径、CHA2DS2-VASc评分明显增大,左心室射血分数降低,与非卒中组相比差异均有统计学意义(均P<0.05)。卒中组高血压和冠心病的患病率均更高(均P<0.001)。卒中组SUA高于非卒中组[(293.2±70.2)μmmol/L∶(375.0±72.6)μmmol/L],而Hct水平明显低于非卒中组[(42.0±4.7)%∶(39.6±5.1)%],差异均有统计学意义(均P<0.001)。多因素Logistic回归分析显示,SUA(OR=1.025,95%CI:1.017~1.032,P<0.001)和低Hct(OR=3.327,95%CI:1.476~7.500,P=0.004)是房颤脑卒中的独立危险因素。根据ROC曲线确定SUA水平的最佳截点值为321.5μmol/L,ROC曲线下面积为0.801(95%CI:0.767~0.835),敏感性为80%,特异性为69%。结论:高SUA(≥321.5μmol/L)和低Hct水平(男≤42%,女≤37%)是非瓣膜性房颤患者发生脑卒中的独立危险因素。
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收稿日期:  2020-11-01

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