Association Between Serum Uric Acid And Atrial Fibrillation And Study On Related Factors Of TCM Syndromes Of Atrial Fibrillation Complicated With Hyperuricemia

Objective: Through retrospective analysis of clinical data of patients,this study explored the association between serum uric acid and atrial fibrillation and the distribution of TCM syndromes of atrial fibrillation combined with hyperuricemia,providing new ideas and methods for the clinical prevention and treatment of atrial fibrillation and for syndrome differentiation and treatment of atrial fibrillation complicated with hyperuricemia.Material and Methods: 1.We collected the medical records of 2000 formerly hospitalized patients,1000 patients with AF were included in the AF group,1000 agematched patients with sinus rhythm and no history of AF were included in the control group.The serum uric acid level,age,gender,atrial fibrillation subtypes,complications and blood biochemical indexes were compared between the two groups.The risk factors of atrial fibrillation were analyzed by Logistic regression model,and the predictive value of serum uric acid for atrial fibrillation was analyzed by receiver operating characteristic(ROC)curve.2.A total of 305 cases of patients with atrial fibrillation who were consistent with hyperuricemia were selected through statistical analysis.According to the classification of TCM syndrome types,the distribution of TCM syndrome types of atrial fibrillation complicated with hyperuricemia was statistically analyzed.Analysis of variance and Chisquare test were used to compare the differences of basic clinical data and serum biochemical indexes among different TCM syndrome types.Results: 1.Compared with the control group,the SUA levels in the AF group were higher(311.39±91.26 vs.345.91±118.88,P<0.01).Serum uric acid is an independent risk factor for atrial fibrillation(OR=1.004,95%CI: 1.001-1.006,P<0.01).The optimal cut-off value of serum uric acid was 332.5μmol/L in female AF patients,and 429.5μmol/L in male AF patients.SUA levels were positively correlated with PAB,SCr,TG,LDL-C levels(P<0.05),but negatively correlated with HDL-C,APOA1 levels(P<0.05).2.The distribution frequency of TCM syndromes of atrial fibrillation combined with hyperuricemia was in order of qi stagnation and blood stasis syndrome(23.0%)> Qi and Yin deficiency syndrome(21.6%)> phlegm-fire disturbance of the heart syndrome(20.7%)>phlegm-blood stasis interassociation syndrome(17.4%)= Yin deficiency and fire proliferation syndrome(17.4%).There were no significant differences in age and gender between patients with atrial fibrillation complicated with hyperuricemia,but there were significant differences in serum uric acid and LDL-C.The syndrome of phlegm-stasis interassociation is associated with elevated serum uric acid level and dyslipidemia in patients with atrial fibrillation complicated with hyperuricemia.Conclusion: SUA is an independent risk factor for AF.Screening patients with elevated SUA level is helpful for the early diagnosis and treatment of AF.The syndrome of phlegmstasis interassociation is related to the elevated serum uric acid level and dyslipidemia in patients with atrial fibrillation complicated with hyperuricemia.Clinical application of activating blood circulation to remove blood stasis and strengthening spleen and phlegm is helpful to reduce the levels of uric acid blood and blood lipid in patients with atrial fibrillation.