超敏C反应蛋白水平和幽门螺杆菌感染与心房颤动的相关性研究  

Relationship between level of high sensitive C-reactive protein,helicobacter pylori infection and atrial fibrillation

作　　者：王馨 徐俊波[2] 胡咏梅[2] 刘剑雄[2] 李科[2] Wang Xin;Xu Junbo;Hu Yongmei(Graduate School of Zunyi Medical College ,Zunyi 563000,China)

机构地区：[1]遵义医学院研究生院,贵州遵义563000 [2]遵义医学院附属成都市第二人民医院心内科

出　　处：《临床内科杂志》2018年第12期817-820,共4页Journal of Clinical Internal Medicine

摘　　要：目的探讨超敏C反应蛋白(hs-CRP)水平和幽门螺杆菌(HP)感染与心房颤动(AF)的相关性。方法根据心电图检查结果,将121例就诊患者分为AF组68例和对照组53例。分别检测两组患者血甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、hs-CRP水平及左心房内径(LAD)、左心室舒张末内径(LVEDd)、左心室射血分数(LVEF)、颈动脉内膜中层厚度(cIMT)。两组患者均于清晨空腹或进食2 h后行14C呼气试验检测HP感染情况并进行比较。采用Spearman相关分析评估各指标与AF发生的相关性;采用logistic回归分析评估AF发生风险的影响因素;采用受试者工作特征(ROC)曲线分析hs-CRP和LAD预测AF发生的效能。结果AF组LAD、双侧cIMT、hs-CRP水平及HP阳性患者比例高于对照组(P<0.05)。Spearman相关分析结果显示,LAD与AF发生呈高度正相关,hs-CRP、左侧cIMT、右侧cIMT均与AF发生呈中度正相关,HP感染与AF发生呈低度正相关(P<0.05)。Log/st/c回归分析结果显示,hs-CRP水平升高、HP感染及LAD增大均增加AF的发生风险(P<0.05)。ROC曲线分析结果显示,LAD预测AF发生的ROC曲线下面积>hs-CRP。hs-CRP和LAD预测AF发生的最佳临界值分别为2.25 mg/L和35.5 mm。结论hs-CRP水平升高、HP感染及LAD增大可能与AF发生风险增加有关。hs-CRP和LAD预测AF发生的最佳临界值分别为2.25 mg/L和35.5 mm。Objective To investigate the relationship between level of high sensitive C-reactive protein (hs-CRP),helicobacter pylori (HP)infection and atrial fibrillation (AF).Methods According to results of electrocardiogram examination,121 patients were divided into AF group (68 cases)and control group(53 cases).Triglycerides(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C), high density lipoprotein cholesterol(HDL-C),hs-CRP and left atrial diameter(LAD),left ventricular end diastolic diameter(LVEDd),left ventricular ejection fraction (LVEF),carotid intima media thickness (cIMT)were measured in patients of two groups.Patients in two groups underwent 14C breath test on an empty stomach or 2 h after eating to detect HP infection conditions and compare their results.Spearman correlation analysis was used to assess correlations between each index and AF.Logistic regression analysis was used to assess influencing factors of AF risk.Receiver operating characteristic (ROC)curve was used to analyze the efficacy of hs-CRP and LAD in predicting AF.Results LAD,bilateral cIMT,hs-CRP and ratio of patients with HP positive in AF group were higher than those in control group(P <0.05 ).Results of Spearman correlation analysis showed that LAD was highly positively correlated with AF,hs-CRP,left cIMT and right clMT were moderate positively correlated with AF,and HP infection was mild positively correlated with AF (P <0.05 ).Results of logistic regression analysis showed that increased level of hs-CRP,HP infection and enlarged LAD could increase the risk of AF(P <0.05).Results of ROC curve analysis showed that area under ROC curve (AUC)predicting the occurrence of AF by LAD was larger than that by hs-CRP.The optimal cut-off values for predicting the occurrence of AF by hs-CRP and LAD were 2.25 mg/L and 35.5 mm respectively.Conclusion Increased level of hs-CRP,HP infection and enlarged LAD may increase the ocurrence risk of AF.The optimal cut-off values for predicting the occurrence of AF by hs-CRP and LAD were 2.25 mg/L

关 键 词：心房颤动 超敏C反应蛋白 幽门螺杆菌 

分 类 号：R573[医药卫生—消化系统]