阵发性心房颤动患者血清IS、LOXL2、GRP94与经导管射频消融术后复发的关系研究  

Study on Relationship between Serum IS,LOXL2,GRP94 and Recurrence after Radiofrequency Catheter Ablation in Patients with Paroxysmal Atrial Fibrillation

作　　者：连俊 赵柄烨 程晋芳 刘晋文[1] 张志军 LIAN Jun;ZHAO Bing-ye;CHENG Jin-fang;LIU Jin-wen;ZHANG Zhi-jun(Department of Internal Medicine-Cardiovascular,Shanxi Academy of Medical Sciences/Shanxi Bethune Hospital,Taiyuan,Shanxi,030000,China)

机构地区：[1]山西医学科学院/山西白求恩医院心内科,山西太原030000

出　　处：《现代生物医学进展》2024年第14期2660-2665,共6页Progress in Modern Biomedicine

基　　金：山西省基础研究计划项目(202303021211222)。

摘　　要：目的:分析阵发性心房颤动(PAF)患者血清硫酸吲哚酚(IS)、赖氨酰氧化酶样蛋白2(LOXL2)、葡萄糖调节蛋白94(GRP94)与经导管射频消融术后复发的关系。方法:选择2020年1月至2022年1月在本院行导管射频消融术的155例PAF患者,术后随访1年,按照是否复发PAF分为未复发组和复发组,对比两组血清IS、LOXL2、GRP94水平,多因素logistic回归分析影响术后复发的因素。ROC曲线分析血清IS、LOXL2、GRP94及三者联合预测PAF患者导管射频消融术后复发的价值。结果:155例PAF患者术后随访1年发现,复发40例(25.81%);复发组房颤病程、左房内径(LAD)长于未复发组,美国纽约心脏协会(NYHA)心功能分级为Ⅲ级比例多于未复发组,左室射血分数(LVEF)低于未复发组(P<0.05);复发组血清GRP94水平低于未复发组,血清IS、LOXL2水平高于未复发组(P<0.05);多因素Logistic回归分析发现,NYHA心功能分级为Ⅲ级、血清IS水平升高、血清LOXL2水平升高、房颤病程较长、LAD增大是术后复发的危险因素(P<0.05),血清GRP94水平、LVEF升高是保护因素(P<0.05);绘制ROC曲线发现,血清IS、LOXL2、GRP94水平及三者联合预测术后复发的AUC为0.764、0.710、0.806、0.853,其中三者联合预测的AUC显著高于IS、LOXL2、GRP94。结论:导管射频消融术前血清IS、LOXL2水平上升及GRP94水平降低的PAF患者术后复发的风险增加,且三者联合可指导临床识别术后复发高风险人群,实现对术后早期复发风险的预测。Objective:To analyze the relationship between Serum indoxyl sulfate(IS),lysyl oxidase-like protein 2(LOXL2),glucose-regulated protein 94(GRP94)and recurrence after radiofrequency catheter ablation in patients with paroxysmal atrial fibrillation(PAF).Methods:155 patients with PAF who were underwent radiofrequency catheter ablation in our hospital from January 2020 to January 2022 were selected,and followed up for 1 year after operation.The patients were divided into non recurrence group and recurrence group according to whether PAF recurred,and the levels of serum IS,LOXL2 and GRP94 were compared between two groups,and the factors affecting recurrence after operation were analyzed by multivariate logistic regression analysis.The value of serum IS,LOXL2,GRP94 and their combination in predicting the recurrence of patients with PAF after radiofrequency catheter ablation were analyzed by ROC curve.Results:155 patients with PAF were followed up for 1 year after operation,and 40 cases(25.81%)experienced recurrence.The duration of atrial fibrillation and left atrial diameter(LAD)in recurrence group were longer than those in non recurrence group,the proportion of New York Heart Association(NYHA)cardiac function grade III in recurrence group was higher than that in non recurrence group,and the left ventricular ejection fraction(LVEF)in recurrence group was lower than that in non recurrence group(P<0.05).The level of serum GRP94 in recurrent group was lower than that in the non recurrent group,and the levels of serum IS and LOXL2 were higher than those in non recurrent group(P<0.05).Multivariate logistic regression analysis showed that,NYHA cardiac function grade III,elevated serum IS levels,elevated serum LOXL2 levels,longer duration of atrial fibrillation,and increased LAD were risk factors for recurrence after operation(P<0.05),and elevated serum GRP94 levels and elevated LVEF were protective factors(P<0.05).The ROC curve showed that,the AUC of serum IS,LOXL2,GRP94 levels and their combination in predicting recurrence af

关 键 词：阵发性心房颤动 硫酸吲哚酚 赖氨酰氧化酶样蛋白2 葡萄糖调节蛋白94 导管射频消融术 复发 

分 类 号：R541.75[医药卫生—心血管疾病]