心房颤动患者血清sST-2、apelin、NT-proBNP、炎症因子浓度与左心房内径的关系  

Relationship between sST-2,apelin,NT-ProBNP,inflammatory factors and left atrial diameter in patients with atrial fibrillation

作　　者：富丽娟[1] 赵晓静[1] 胡微[1] 张明明[1] 皮林[1] 崔炜[2] FU Li-juan;ZHAO Xiao-jing;HU Wei;ZHANG Ming-ming;PI Lin;CUI Wei(Department of Cardiology,Beijing Chuiyangliu Hospital,Beijing 100021,China;Department of Cardiolo. gy,Second Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]北京市垂杨柳医院心内科,北京100021 [2]河北医科大学第二医院心内科,石家庄050000

出　　处：《岭南心血管病杂志》2019年第5期530-535,共6页South China Journal of Cardiovascular Diseases

基　　金：河北省科技计划（项目编号：16277738D）

摘　　要：目的探讨心房颤动(atrial fibrillation,AF)患者血清可溶性人基质裂解素2(soluble suppression of tumorigenicity 2,sST2)、爱帕琳肽(apelin)、N末端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NTproBNP)、左心房内径及炎症因子间的关系。方法2015年2月到2018年2月,采用回顾性研究方法,选择在北京市垂杨柳医院门诊、住院患者70例[AF组40例、器质性心脏病非AF组(NAF组)30例]及健康查体者30名(健康对照组)。检测3组血清sST-2、apelin、NT-proBNP、C反应蛋白(C-reactive protein,CRP)浓度,采用超声心动图检查左心房内径并进行相关性分析。结果AF组、NAF组与健康对照组的左心房内径分别为(44.22±2.09)mm、(37.59±3.19)mm和(34.59±1.48)mm,两两对比差异有统计学意义(P<0.05)。AF组血清sST-2、NT-proBNP、CRP浓度高于NAF组与健康对照组,apelin低于NAF组与健康对照组,差异有统计学意义(P<0.05);NAF组上述指标与健康对照组比较,差异有统计学意义(P<0.05)。在AF组中,直线相关分析结果显示左心房内径与血清sST-2、NT-ProBNP、CRP浓度呈现显著正相关(P<0.05),与血清apelin浓度呈现显著负相关(P<0.05)。单因素Logistic回归分析显示,与AF左心房内径有关的因素有sST-2、NT-proBNP、CRP、apelin、低密度脂蛋白胆固醇、肌酐、尿酸等(P<0.05);多因素Logistic回归分析显示sST-2(OR=3.770)、NT-ProBNP(OR=3.624)、CRP(OR=1.879)、apelin(OR=2.034)为影响AF左心房内径的独立因素(P<0.05)。结论AF患者伴随有左心房内径的扩大与血清sST-2、apelin、NT-proBNP、CRP的分泌异常,上述指标存在相关性。sST-2、apelin、NT-ProBNP、CRP为影响AF患者左心房内径的独立因素。Objectives To investigate the relationship between soluble suppression of tumorigenicity 2(sST-2),apelin, N-terminal pro-brain natriuretic peptide(NT-proBNP),inflammatory factors and left atrial diameter in patients with atrial fibrillation(AF).Methods From February 2015 to February 2018,40 patients with AF(AF group),30 patients with organic heart disease and non AF(NAF group)and 30 cases of healthy persons(control group)were selected in Beijing Chuiyangliu Hospital.Serum concentrations of sST-2,apelin,NT-proBNP and CRP in the 3 groups were detected.Left atrial diameters of the 3 groups were detected by ultrasound.Correlation analysis were carried out among the indexes.Results Left atrial diameter of AF group,NAF group and healthy control group were(44.22±2.09)mm,(37.59±3.19)mm and(34.59±1.48)mm respectively.Differences of left atrial diameter among the 3 groups were statistical significant(P<0.05).Serum concentrations of sST-2,NT-proBNP and CRP in AF group were sig.nificantly higher than those in NAF group and control group;serum concentration of apelin was significantly lower in AF group than that in NAF group and control group(P<0.05).Differences of serum concentrations of sST-2,NTproBNP, CRP and apelin between NAF group and control group were also statistically significant(P<0.05).In AF group,linear correlation analysis showed that left atrial diameter were positively correlated with sST-2,NT-proBNP, CRP(P<0.05),and negatively correlated with apelin(P<0.05).Single factor Logistic regression analysis showed that factors related to left atrial diameter of AF were sST-2,NT-proBNP,CRP,apelin,low-density lipoprotein cholesterol,creatinine,uric acid,etc(P<0.05).Multivariate Logistic regression analysis showed that sST-2(OR=3.770),NTproBNP(OR=3.624),CRP(OR=1.879),apelin(OR=2.034)were independent factors affected left atrial diameter of AF(P<0.05).Conclusions Patients with AF are associated with increase of left ventricular diameter and the abnormal secretion of serum sST-2,apelin,NT-proBNP and CRP.The above index

关 键 词：心房颤动 左心房内径 可溶性人基质裂解素2 爱帕琳肽 N末端脑钠肽前体 

分 类 号：R541.7[医药卫生—心血管疾病]