心房颤动患者血清血小板衍生生长因子和内皮素-1水平与心脏重构及脑卒中的相关性研究  

Relationship between serum platelet derived growth factor and endothelin-1 levels and cardiac remodeling and stroke in patients with atrial fibrillation

作　　者：陶苗苗 高彦琳 侯庆兵 TAO Miaomiao;GAO Yanlin;HOU Qingbing(Department of Ultrasound,The Second People's Hospital of Anhui Province,Hefei 230000,China)

机构地区：[1]安徽省第二人民医院超声医学科,230000 [2]安徽省第二人民医院心血管内科,230000

出　　处：《心肺血管病杂志》2024年第6期587-592,共6页Journal of Cardiovascular and Pulmonary Diseases

基　　金：安徽省教育厅重点项目(2023AH053377);安徽医科大学校科研基金(2021xkj117)。

摘　　要：目的:探观察心房颤动患者血清血小板衍生生长因子(platelet-derived growth factor,PDGF)和内皮素-1(endothelin-1,ET-1)表达水平与心脏重构及脑卒中的相关性。方法:入选193例我院确诊的心房颤动患者,分为阵发性心房颤动组(44例)和非阵发性心房颤动组(149例),选取同期入院的窦性心律患者30例为对照组。酶联免疫吸附测定检测患者血清PDGF和ET-1水平,评估两者与超声心动图指标和卒中的相关性。结果:非阵发性心房颤动组血清PDGF、ET-1含量、左心房内径(left atrial diameter,LAD)和LVESD值高于对照组和阵发性心房颤动组而LVEF值降低于两组(P<0.05);非阵发性心房颤动组LVEDD值高于阵发性心房颤动组(P<0.05);心房颤动患者血清PDGF和ET-1呈现线性正相关(r=0.248,P<0.001)且两者与左心房内径呈正相关(r值分别为0.276和0.331,P<0.01);心房颤动患者左心房重构组血清PDGF和ET-1明显高于非心房重构组(P<0.05)。ROC曲线结果显示,血清PDGF水平诊断心房颤动患者发生心房重构的ROC曲线下面积AUC=0.634(95%CI:0.553~0.714);血清ET-1水平诊断心房颤动患者发生心房重构的AUC=0.674(95%CI:0.598~0.750);两者联合诊断的AUC=0.698(95%CI:0.625~0.771);心房颤动合并卒中组患者血清PDGF和ET-1明显高于单纯心房颤动组(P<0.05)。血清PDGF水平诊断心房颤动患者卒中发生的AUC=0.630(95%CI:0.551~0.708);血清ET-1水平诊断心房颤动患者卒中发生的AUC=0.682(95%CI:0.607~0.757);两者联合诊断的AUC=0.706(95%CI:0.633~0.780)。结论:血清PDGF及ET-1与心房颤动诊断、心脏重构及脑卒中有相关性,血清PDGF及ET-1为心房颤动患者心脏重构及脑卒中发生的预测指标。Objective:To observe the correlation between the expression levels of platelet derived growth factor(PDGF)and endothelin-1(ET-1)in patients with atrial fibrillation and cardiac remodeling and stroke in patients with atrial fibrillation.Methods:A total of 193 patients with confirmed AF in our hospital were selected and divided into paroxysmal AF group (44 cases) and non-paroxysmal AF group (149 cases) according to their medical history and related examinations. 30 patients with sinus rhythm admitted at the same time were selected as the control group. enzyme-linked immunosorbent assay (ELISA) was used to detect serum PDGF and ET-1 levels in patients to assess their correlation with echocardiographic indicators and stroke. Results: Serum levels of PDGF, ET-1, LAD and LVEDD in non-paroxysmal atrial fibrillation group LVESD was higher than that of control group and parsmal atrial fibrillation group, and LVEF was lower than that of the two groups (P< 0.05). The LVEDD in non-paroxysmal atrial fibrillation group was higher than that in paroxysmal atrial fibrillation group (P< 0.05). There was a linear positive correlation between PDGF and ET-1 in patients with atrial fibrillation (r=0.248, P<0.001), and a positive correlation between PDGF and ET-1 in patients with atrial fibrillation (r= 0.276 and 0.331, P< 0.01). Serum PDGF and ET-1 in left atrial remodeling group were significantly higher than those in non-atrial remodeling group (P< 0.05). The results of receiver operating characteristic (ROC) mapping showed that the area under curve (ROC) of atrial remodeling in patients diagnosed with atrial fibrillation by serum PDGF level. AUC was 0.634 (95%CI:0.553-0.714);The AUC for atrial remodeling in patients diagnosed with atrial fibrillation at serum ET-1 level was 0.674 (95%CI:0.598-0.750);The AUC of combined diagnosis was 0.698 (95%CI:0.625-0.771). Serum PDGF and ET-1 in patients with atrial fibrillation combined with stroke were significantly higher than those in patients with atrial fibrillation alone (P< 0.05). ROC cu

关 键 词：心房颤动 血小板衍生生长因子 内皮素-1 心室重构 卒中 

分 类 号：R54[医药卫生—心血管疾病]