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高尿酸水平可预测经食管超声心动图检测到的左心房血栓或自发显影:荟萃分析与系统评价。

High uric acid level predicts left atrial thrombus or spontaneous echo contrast detected by transesophageal echocardiography: Meta-analysis and systematic review.

作者信息

Zhang En-Yuan, Kou Lu, Li Min, Ng Chee Yuan, Zhao Jian-Ping, Li Guang-Ping, Liu Tong

机构信息

Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, China.

Tianjin Chest Hospital, Tianjin 300051, China.

出版信息

Chronic Dis Transl Med. 2016 Apr 6;2(1):27-33. doi: 10.1016/j.cdtm.2016.02.002. eCollection 2016 Mar.

DOI:10.1016/j.cdtm.2016.02.002
PMID:29063022
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5643743/
Abstract

BACKGROUND

Recent observational studies have suggested that the patients with hyperuricemia have a higher risk of having left atrial thrombus (LATH) or left atrial spontaneous echo contrast (LASEC) by transesophageal echocardiography (TEE), while the ultimate predictive value of a high uric acid (UA) level on LATH/LASEC remained obscure.

METHODS

We searched the PubMed and Cochrane clinical trials databases up to July 2015. Following screening the 369 initially identified studies, we analyzed six observational studies with 2381 patients.

RESULTS

The meta-analysis of these studies showed that an elevated serum UA level was associated with a higher likelihood of LATH/LASEC ( = 1.59, 95% 1.13-2.23,  = 0.008), while significant differences exist among individual trials ( < 0.00001 and  = 85%). Sensitivity analysis failed to find any heterogeneity.

CONCLUSION

An elevated UA level was associated with a higher risk of detecting a left atrial abnormality represented by LATH/LASEC.

摘要

背景

近期的观察性研究表明,高尿酸血症患者经食管超声心动图(TEE)检查发现左心房血栓(LATH)或左心房自发显影(LASEC)的风险更高,而高尿酸(UA)水平对LATH/LASEC的最终预测价值仍不明确。

方法

我们检索了截至2015年7月的PubMed和Cochrane临床试验数据库。在筛选了最初识别出的369项研究后,我们分析了6项包含2381例患者的观察性研究。

结果

这些研究的荟萃分析表明,血清尿酸水平升高与LATH/LASEC的可能性增加相关(比值比=1.59,95%置信区间1.13 - 2.23,P = 0.008),而各试验之间存在显著差异(I²<0.00001,异质性检验P = 85%)。敏感性分析未发现任何异质性。

结论

尿酸水平升高与检测到以LATH/LASEC为代表的左心房异常的较高风险相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d021/5643743/2132945089cc/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d021/5643743/5415e6aefcad/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d021/5643743/9712d752edc0/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d021/5643743/57e3170be3d5/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d021/5643743/2132945089cc/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d021/5643743/5415e6aefcad/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d021/5643743/9712d752edc0/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d021/5643743/57e3170be3d5/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d021/5643743/2132945089cc/gr4.jpg

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本文引用的文献

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Echocardiography. 2015 Oct;32(10):1477-82. doi: 10.1111/echo.12897. Epub 2015 Feb 2.
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Serum uric acid and risk of left atrial thrombus in patients with nonvalvular atrial fibrillation.血清尿酸与非瓣膜性心房颤动患者左心房血栓形成的风险。
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Red blood cell distribution width and left atrial thrombus or spontaneous echo contrast in patients with non-valvular atrial fibrillation.
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Usefulness of the uric acid and CHA₂DS₂-VASc score in prediction of left atrial thrombosis in patients with mitral stenosis and sinus rhythm.尿酸和CHA₂DS₂-VASc评分在预测二尖瓣狭窄合并窦性心律患者左心房血栓形成中的应用价值。
Cardiol J. 2015;22(3):336-42. doi: 10.5603/CJ.a2014.0059.
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Hyperuricemia and transesophageal echocardiographic thromboembolic risk in patients with atrial fibrillation at clinically low-intermediate risk.临床中低风险心房颤动患者的高尿酸血症与经食管超声心动图检查的血栓栓塞风险
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