血清B型脑钠肽、胰岛素样生成因子结合蛋白-3水平与非酒精性脂肪肝患者心房颤动的关系  

Relationships of serum levels of B-type natriuretic peptide and insulin-like growth factor binding protein-3 with atrial fibrillation in patients with non-alcoholic fatty liver disease

作　　者：李艳 韩丽 LI Yan;HAN Li(Department of Laboratory Medicine,the Fourth People′s Hospital of Nanchong City of Sichuan Province,Nanchong,Sichuan,637000)

机构地区：[1]四川省南充市第四人民医院检验科,四川南充637000

出　　处：《实用临床医药杂志》2024年第7期101-105,109,共6页Journal of Clinical Medicine in Practice

基　　金：2020年四川省医学会(青年创新)科研课题项目(S20112)。

摘　　要：目的探讨非酒精性脂肪肝(NAFLD)患者血清B型脑钠肽(BNP)、胰岛素样生成因子结合蛋白-3(IGFBP-3)水平与心房颤动发生的关系。方法选取105例NAFLD患者纳入观察组,另选取105例健康体检者纳入对照组。收集患者的临床资料,比较2组血清BNP、IGFBP-3水平,分析NAFLD患者发生心房颤动的影响因素,探讨血清BNP、IGFBP-3的交互作用对NAFLD患者心房颤动发生风险的影响,评估血清BNP、IGFBP-3水平对NAFLD患者心房颤动的预测价值。结果观察组血清BNP、IGFBP-3水平高于对照组,差异有统计学意义(P<0.05);观察组患者1年内发生心房颤动30例,心房颤动患者的体质量指数(BMI)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、BNP和IGFBP-3水平均高于未发生心房颤动患者,高密度脂蛋白胆固醇(HDL-C)水平低于未发生心房颤动患者,差异有统计学意义(P<0.05);BMI、TC、TG、HDL-C、LDL-C、BNP和IGFBP-3均为NAFLD患者发生心房颤动的影响因素(P<0.05);BNP、IGFBP-3存在交互作用,且NAFLD患者心房颤动发生风险中有50.47%归因于两者交互作用;血清BNP、IGFBP-3联合预测的曲线下面积为0.928,显著大于BNP、IGFBP-3单独预测的曲线下面积0.753、0.821(P<0.05)。结论BNP、IGFBP-3在NAFLD患者血清中的表达水平显著升高,两者联用可有效预测患者心房颤动的发生。Objective To investigate the relationships of serum levels of B-type natriuretic peptide(BNP)and insulin-like growth factor binding protein-3(IGFBP-3)with the occurrence of atrial fibrillation in patients with non-alcoholic fatty liver disease(NAFLD).Methods A total of 105 patients with NAFLD were included in observation group,and another 105 healthy individuals were included in control group.Clinical data of the patients were collected,and serum levels of BNP and IGFBP-3 were compared between the two groups.The influencing factors of atrial fibrillation in patients with NAFLD were analyzed,and the interactive effects of serum BNP and IGFBP-3 on the risk of atrial fibrillation in patients with NAFLD were explored.The predictive value of serum BNP and IGFBP-3 levels for atrial fibrillation in patients with NAFLD was also evaluated.Results The serum levels of BNP and IGFBP-3 in the observation group were significantly higher than those in the control group(P<0.05).Among the patients in the observation group,30 cases developed atrial fibrillation within one year.The levels of body mass index(BMI),triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),BNP,and IGFBP-3 were higher in patients with atrial fibrillation compared to those without,while the level of high-density lipoprotein cholesterol(HDL-C)was lower(P<0.05).BMI,TC,TG,HDL-C,LDL-C,BNP,and IGFBP-3 were all influencing factors for the occurrence of atrial fibrillation in patients with NAFLD(P<0.05).There was an interaction between BNP and IGFBP-3,50.47%of the risk of atrial fibrillation in patients with NAFLD was attributed to this interaction.The area under the curve for the combined prediction of serum BNP and IGFBP-3 was 0.928,which was significantly larger than the AUC of 0.753 and 0.821 for the individual predictions of BNP and IGFBP-3,respectively(P<0.05).Conclusion The expression levels of BNP and IGFBP-3 in the serum of patients with NAFLD are significantly elevated,and the combined use of these markers can effectively pred

关 键 词：非酒精性脂肪肝 心房颤动 B型脑钠肽 胰岛素样生成因子结合蛋白-3 

分 类 号：R575[医药卫生—消化系统] R541.7[医药卫生—内科学] R446.11[医药卫生—临床医学]