活化T细胞核因子4和白介素6与非瓣膜性心房颤动的相关性研究  

The correlation between NFATc4 and IL-6 and non-valvular atrial fibrillation

作　　者：朱明利 康品方[1] 徐庆梅 谢彩侠[1] 刘晨阳 宣玲[1] 张恒[1] 唐碧[1] ZHU Ming-li;KANG Pin-fang;XU Qing-mei;XIE Cai-xia;LIU Chen-yang;XUAN Ling;ZHANG Heng;TANG Bi(Department of Cardiovascular,The FirstAffiliated Hospital of Bengbu Medical College,Bengbu 233004,China;Research Center of Cardiovascular and Cerebrovascular Diseases of Bengbu Medical College,Bengbu 233000,China)

机构地区：[1]蚌埠医学院第一附属医院心内科,安徽省蚌埠市233004 [2]蚌埠医学院心脑血管病研究中心

出　　处：《中国心血管病研究》2021年第2期111-116,共6页Chinese Journal of Cardiovascular Research

基　　金：国家自然科学基金面上项目(81970313、81170803);安徽省自然科学基金青年基金资助项目(1908085QH353);教育部留学回归人员科研启动基金(第46批-教外司留[2013]693号);安徽省科技攻关项目(1804h08020246)。

摘　　要：目的探究活化T细胞核因子4(NFATc4)和炎性细胞因子白介素6(L~6)水平与非瓣膜性心房颤动的关系及其对非辦膜性心房颤动的诊断价值,同时分析非瓣膜性心房颤动发病的危险因素。方法根据签署人组知情同意书及排除标准,利用SAS系统的PLAN过程选取2019年6~12月就诊于蚌埠医学院第一附属医院心内科诊断为非瓣膜性心房颤动患者80例作为研究对象,其中阵发性心房颤动患者40例,持续性心房颤动患者40例。利用SAS系统的PLAN过程选取同期我院体检健康者(窦性心律)38例作为对照组。收集患者临床资料,采用超声心动图测量受试者左心房内径(LAD)和左心室射血分数(LVEF)等。并于次日清晨抽取受试者空腹状态下静脉血约5ml,采用酶联免疫吸附法(ELISA)检测血清NFATc4和IL-6水平,记录受试者血常规、生化常规中的尿酸(SUA)和中性粒细胞与淋巴细胞比值(NLR)。比较各组间指标的差异,探究NFATc4、IL-6、SUA和NLR与非瓣膜性心房颤动之间的关系;采用二元Logistic回归分析非瓣膜性心房颤动发病的影响因素,采用受试者工作特征(ROC)曲线分析血清NFATc4、IL-6、SUA和NLR水平对非瓣膜性心房颤动发病的预测价值。结果①阵发性心房颤动组NFATc4(651.08±70.93)pg/ml、IL-6(60.24±2.55)ng/L、SUA(351.61±78.60)μmol/L、NLR(2.27±1.06)、LAD(54.18±4.02)mm;持续性心房颤动组NFATc4(699.69±99.11)pg/ml、IL-6(98.73±6.13)ng/L、SUA(394.54±76.70)μmol/L、NLR(2.56±1.51)、LAD(57.58±4.09)mm;对照组NFATc4(589.27±58.48)pg/ml、IL-6(48.26±13.54)ng/L、SUA(314.60±74.90)μmol/L、NLR(1.65±0.89)LAD(22.16±3.13)mm;对照组、阵发性房颤组及持续性房颤组中血清NFATc4、IL-6、SUA、NLR和LAD值依次升高,组间差异具有统计学意义(P<0.05)。②非瓣膜性心房颤动患者外周血中NFATc4、IL-6、SUA和NLR表达水平与LAD存在正相关性(r=0.481、0.637、0.331、0.336,P<0.05)。③二元Logistic回归分析显示,NFATc4、IObjective To explore the relationship between activated T cell nuclear factor 4(NFATc4),inflammatory cytokine interleukin 6(IL-6)levels and non-valvular atrial frilation and its diagnostic value for atrial fibrillation and analyze the risk factors of atrial firillation.Methods According to the signed informed consent form and exclusion criteria,80 patients with non-valvular atrial fibrillation diagnoscd in the Department of Cardiology of the First Affiliated Hospital of Bengbu Medical College from June 2019 to December 2019 were randomly selected as the research objects,including 40 patients with paroxysmal atrial fibrillation and with 40 patients persistent atrial fibrillation.Randomly selected 38 cases of healthy people(sinus rhythm)in our bospital during the same period as the control group.The clinical data of the patients were collected and the echocardiography was used to measure the left atrial diameter(LAD)and left ventricular ejection fraction(LVEF)of the subjects.In the early morning of the next day,about 5 mI of venous blood was taken from the subjects in the fasting state and the levels of serum NFATc4 and IL-6 were detected by enzyme-linked immunosorbent assay(ELISA);the uric acid value(SUA)and the ratio of neutrophils to lymphocytes(NLR)were determined.The diffcrences of the indicators between the groups were compared,and the relationship between NFATc4,IL-6,.SUA,NLR and the atrial fibrillation were explored;binary Logistic regression were uesd to analyze the influencing factors of atrial fibrillation;the receiver operating characteristic(ROC)curve analysis was used to get the predictive value of serum NFATc4,IL-6,SUA and NLR levels in the onset of atrial fibrillation.Results(1)In paroxysmal atrial firiltion group,NFATc4(651.08±70.93)pg/ml,IL-6(60.24±2.55)ng/L,SUA(351.61±78.60)μmol/L,NLR(2.27±1.06),LAD(54.18±4.02)mm;persistent atrial frillation group NFATc4(699.69±99.11)pg/ml,IL-6(98.73±6.13)ng/L,SUA(394.54±76.70)μmol/L,NLR(2.56±1.51),LAD(57.58±4.09)mm;control group NFATc4(589.27±58.48)

关 键 词：心房颤动 活化T细胞核因子4 白介素6 左心房内径 尿酸 中性粒细胞和淋巴细胞比值 

分 类 号：R541.7[医药卫生—心血管疾病]