高尿酸血症与心房颤动患者全因死亡的关系

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目的:探讨高尿酸血症是否为心房颤动患者发生全因死亡的独立危险因素。方法:选取2006至2007年度于开滦集团所属11家医院参加开滦集团职工健康体检经12导联心电图证实为心房颤动的患者为研究对象。采用前瞻性队列研究方法对所有入选患者进行随访,观察队列中发生全因死亡的情况,末次随访时间为2013年12月31日。采用Kaplan-Meier曲线及Cox比例风险模型分析并比较高尿酸血症组与正常尿酸组心房颤动患者全因死亡的发生风险。结果:共388例社区心房颤动患者纳入最终统计分析,在平均6.93年的随访期间,共发生全因死亡136例。高尿酸血症组及正常尿酸组心房颤动患者全因死亡的发生率每年分别为9.24%(36/390)、5.16%(100/1 937)。在单因素Cox比例风险模型分析中,高尿酸血症组心房颤动患者发生全因死亡的风险比(95%n CI)是正常尿酸组的1.84(1.26~2.69)倍(n P<0.01)。在校正潜在混杂变量的基础上,高尿酸血症组心房颤动患者发生全因死亡的校正风险比(95%n CI)仍是正常尿酸组的1.94(1.32~2.85)倍(n P<0.01)。在校正潜在的混杂变量情况下,尿酸每升高0.01 g/L(1 g/L=5 950 μmol/L),心房颤动患者发生全因死亡的风险增加1.15(1.05~1.26)倍(n P<0.01)。n 结论:高尿酸血症是社区心房颤动患者全因死亡发生的独立危险因素。“,”Objective:To explore whether hyperuricemia was an independent risk factor for all-cause mortality in patients with atrial fibrillation.Methods:Patients with atrial fibrillation who were confirmed by 12-lead electrocardiogram in 11 hospitals of Kailuan Group from 2006 to 2007 were selected as the research objects.All patients were followed up by prospective cohort study, and all-cause deaths were observed.The last follow-up time was December 31, 2013.Kaplan-Meier curve and Cox proportional hazards model were used to analyze and compare the risk of all-cause mortality in patients with atrial fibrillation in the hyperuricemia group compared with the normal uric acid group.Results:A total of 388 community-based patients with atrial fibrillation were included in the final statistical analysis, with 136 all-cause deaths occurred during an average follow-up period of 6.93 years.The incidence of all-cause mortality was 9.24% per year(36/390)in the hyperuricemia group, whereas 5.16% per year(100/1 937) in the normal uric acid group.In the univariate Cox proportional risk model analysis, the risk ratio (95%n CI) of all-cause death in patients with atrial fibrillation in the hyperuricemia group (95%n CI) was 1.84(1.26-2.69) times that in the normal uric acid group (n P<0.01). After adjusting for potential confounding variables, the adjusted risk ratio (95% CI) of all-cause death in patients with atrial fibrillation in hyperuricemia group was still 1.94(1.32-2.85) times of that in normal uric acid group (n P<0.01). After adjustment for potential confounding variables, for each 0.01 g/L increase in uric acid (1 g/L=5 950 μmol/L), the risk of all-cause death in patients with atrial fibrillation increased by 1.15 (1.05-1.26) times (n P<0.01).n Conclusion:Hyperuricemia was an independent risk factor for all-cause death in patients with atrial fibrillation in community.
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