生物瓣膜与机械瓣膜置换治疗心脏瓣膜病:血清Apelin-12检测的价值  

Biovalve and meachanical valve replacement for valvular disease:the value of serum Apelin-12 detection

作　　者：侯鹏[1] 王辉山[2] 韩劲松[2] 

机构地区：[1]解放军第四军医大学研究生院,陕西省西安市710032 [2]解放军沈阳军区总医院心血管外科,辽宁省沈阳市110016

出　　处：《中国组织工程研究》2015年第16期2583-2587,共5页Chinese Journal of Tissue Engineering Research

基　　金：辽宁省自然科学基金项目(2014020065);辽宁省科学技术攻关项目(2012225005)~~

摘　　要：背景:人工瓣膜置换治疗心脏瓣膜疾病具有良好的生物相容性和血流动力学特性,但仍有很多因素影响其治疗效果。目的:检测瓣膜病合并心房颤动患者人工瓣膜置换前的血清Apelin-12水平。方法:纳入心脏瓣膜病拟行人工瓣膜置换患者62例,其中男33例,女29例,年龄(55±11)岁,其中合并持续性心房颤动患者30例(心房颤动组),窦性心律患者32例(窦性心律组),检测两组入院时血清Apelin-12与炎症及氧化应激相关标志物的水平。瓣膜置换后又将窦性心律组分为术后心房颤动组(n=8)与非心房颤动组(n=24),比较两组置换前血清Apelin-12与炎症及氧化应激相关标志物的水平。结果与结论:心房颤动组血清Apelin-12水平低于窦性心律组(P<0.05),超敏C-反应蛋白、白细胞介素6、总抗氧化能力高于窦性心律组(P<0.05)。相关分析显示,Apelin-12与超敏C-反应蛋白、总抗氧化能力呈负相关(r=-0.265,P=0.045;r=-0.960,P<0.001),与白细胞介素6无明显相关性(r=-0.155,P=0.230)。术后心房颤动组血清Apelin-12水平低于非心房颤动组(P<0.05),左房内径、超敏C-反应蛋白水平高于非心房颤动组(P<0.05)。表明Apelin-12可能通过调节炎症及氧化应激参与心房颤动的发生与维持,血清Apelin-12检测对预测术后心房颤动发生有一定的价值。BACKGROUND： Artificial valve replacement for valvular disease has good biocompatibility and hemodynamic characteristics, but there are still many factors that affect its therapeutic effects. OBJECTIVE： To detect the level of serum Apelin-12 in the perioperative period of valve replacement in valvular disease patients with atrial fibrillation. METHODS： Sixty-two patients with valvular heart disease scheduled for artificial valve replacement were selected, including 30 patients with persistent atrial fibrillation （atrial fibrillation group） and 32 patients with sinus rhythm （sinus rhythm group）. There were 33 males and 29 females, with a mean age of （55±11） years. Levels of serum Apelin-12 and makers related to inflammation and oxidative stress were detected in two groups at admission. Furthermore, the sinus rhythm group was sub-divided into postoperative atrial fibrillation （POAF） group （n=8） and non-POAF group （n=24） after valve replacement, and the above-mentioned indicators were detected and compared between these two subgroups. RESULTS AND CONCLUSION： Compared with the sinus rhythm group, the serum level of Apelin-12 was significantly lower in the atrial fibrillation group, while the levels of high-sensitivity C-reactive protein and interleukin-6 and total antioxidant capacity were significantly higher in the atrial fibrillation group （P〈 0.05）. Correlation analysis showed that the serum level of Apelin-12 was negatively correlated with high-sensitivity C-reactive protein level and total antioxidant capacity （t=-0.265,/〉=-0.045; r=-0.960, P 〈 0.001）, but not correlated with the interleukin-6 level （t=-0.155, P=0.230）. Compared with the non-POAF group, the serum level of Apelin-12 was significantly lower in the POAF group （P 〈 0.05）, but the left atrial diameter, high-sensitivity C-reactive protein level were higher in the POAF group （P 〈 0.05）. Apelin-12 may take part in the occurrence and maintenance of atrial fibrillation through the regulation o

关 键 词：心脏瓣膜 人工 心房颤动 心脏瓣膜疾病 生物材料 材料相容性 人工瓣膜 置换 APELIN-12 炎症 氧化应激 辽宁省自然科学基金 

分 类 号：R318[医药卫生—生物医学工程]