生长激素释放肽-肥胖抑制素对心房颤动患者左房重构的影响机制探讨  

Study on the mechanism of the influence of ghrelin-obestatin on left atrial remodeling in patients with atrial fibrillation

作　　者：秦亚录 庄光彤[1] 黄爱玲 袁典 莫思琪 毛天珍 阳坤袁 徐莲 陈曾宇 王一博 QIN Ya-lu;ZHUANG Guang-tong;HUANG Ai-ling;YUAN Dian;MO Si-qi;MAO Tian-zhen;YANG Kun-yuan;XU Lian;CHEN Zeng-yu;WANG Yi-bo(Department of Cardiology,The Third Affiliated Hospital of Chengdu University of TCM/Chengdu Pidu District Hospital of TCM,Chengdu 611730,China;Department of Laboratory Medicine,The Third Affiliated Hospital of Chengdu University of TCM/Chengdu Pidu District Hospital of TCM,Chengdu 611730,China;Clinical Medical College,Chengdu University of Traditional Chinese Medicine,Chengdu 610075,China)

机构地区：[1]成都中医药大学附属第三医院/成都市郫都区中医医院心病科,四川成都611730 [2]成都中医药大学附属第三医院/成都市郫都区中医医院实验医学科,四川成都611730 [3]成都中医药大学临床医学院,四川成都610075

出　　处：《实用医院临床杂志》2024年第4期89-92,共4页Practical Journal of Clinical Medicine

基　　金：四川省医学青年创新科研课题计划(编号Q21091);成都市医学科研课题(编号:2021259);四川省中医药管理局2023年中医药科研专项课题(编号:2023MS046)。

摘　　要：目的 探讨生长激素释放肽-肥胖抑制素系统对心房颤动患者炎症因子的调节作用及其与左房容积指数的相关性。方法 81例心房颤动患者(房颤组)和80例健康对照组(对照组),测定血清生长激素释放肽(Ghrelin)、肥胖抑制素(Obestatin)、白细胞介素-18(IL-18)和白细胞介素-6(IL-6)水平、C反应蛋白(CRP)水平,房颤组患者行超声心动图检查,计算左房容积指数(LAVI);分析LAVI与Ghrelin、Obestatin与IL-18、IL-6及CRP水平的相关性。结果 房颤组患者血清Ghrelin和IL-18、IL-6及CRP的表达水平均高于对照组,Obestatin的表达水平低于对照组,差异有统计学意义(P<0.05);亚组分析中,阵发性房颤组、持续性房颤组及永久性房颤组患者血清Ghrelin和IL-18、IL-6及CRP的表达水平依次升高,而Obestatin表达水平逐渐降低(P<0.05)。Spearman秩相关性分析结果显示,房颤组患者LAVI与外周血Ghrelin与IL-18、IL-6及CRP水平呈正相关,与Obestatin水平呈负相关(P<0.01)。结论 心房颤动患者外周血Ghrelin、IL-18、IL-6及CRP表达增高,Obestatin表达的降低与左房结构重构有关,推测心房颤动患者左房结构重构可能与通过Ghrelin-Obestatin系统调节炎症因子有关。Objective To investigate the regulatory effect of releasing peptide-obestatin system on inflammatory factors in patients with atrial fibrillation and its relationship with left atrial volume index.Methods Eighty-one patients with atrial fibrillation were selected as atrial fibrillation group.Another 80 healthy controls were selected as control group.Levels of serum ghrelin,obestatin,interleukin-18(IL-18),interleukin-6(IL-6)and C-reactive protein(CRP)were measured.Left atrial volume index(LAVI)was calculated by echocardiography in patients with atrial fibrillation.The correlation between the LAVI and the levels of ghrelin,obestatin,IL-18,IL-6 and CRP was analyzed.Results The expression levels of serum ghrelin,IL-18,IL-6 and CRP were higher while the expression level of obestatin was lower in the atrial fibrillation group than those in the control group(P<0.05).In subgroup analysis,the expression levels of serum ghrelin,IL-18,IL-6 and CRP in patients with paroxysmal atrial fibrllation,persistent atrial fibrillation and permanent atrial fibrillation were sequentially increased(P<0.05).The expression levels of obestatin in those subgroups were gradually decreased(P<0.05).Spearman rank correlation analysis showed that the LAVI in the atrial fibrillation group was positively correlated with the levels of peripheral blood ghrelin,IL-18,IL-6,and CRP(all P<0.01),while negatively correlated with obestatin levels(P<0.01).Conclusions The expression of ghrelin,IL-18,IL-6 and CRP in the peripheral blood of patients with atrial fibrillation is increased,and the expression of obestatin is reduced.These are related to left atrial structural remodeling.The left atrial structural remodeling in patients with atrial fibrllation may be related to the regulation of inflammatory factors through the ghrelin-obestatin system.

关 键 词：心房颤动 生长素释放肽 肥胖抑制素 白细胞介素-18 白细胞介素-6 C反应蛋白 

分 类 号：R541.7[医药卫生—心血管疾病]