不同类型房颤患者血浆apelin的水平及其意义

Level of plasma apelin and its significance in patients with different types of atrial fibrillation

目的观察不同类型房颤患者血浆apelin的水平及其与N端B型利钠肽前体(NT-proBNP)、左房内径(LAD)的关系。方法 85例房颤患者分为阵发性房颤组(B组)31例、持续性房颤组(C组)29例和永久性房颤组(D组)25例,同期非房颤住院患者为对照组(A组)26例。检测血浆apelin、NT-proBNP,并行心脏超声测定LAD,进行统计学分析。结果与A组相比,B组、C组、D组血浆apelin水平均明显降低(P均<0.05),而D组明显低于B组和C组(P均<0.05),B组与C组之间比较,差异无统计学意义(P>0.05);与A组相比,B组、C组、D组NT-proBNP显著升高(P均<0.05),D组最高,而B组与C组之间比较,差异无统计学意义(P>0.05);LAD在A组、B组、C组、D组之间有明显差异,呈依次递增(P<0.05)。多元相关分析显示:血浆apelin与NT-proBNP、LAD负相关,(r=-0.28、-0.32,P均<0.05)。结论不同类型房颤患者血浆apelin水平降低,可能通过抗纤维化参与心房重构,与房颤的发生和维持相关。

Objective To explore the relationship among the level of plasma apelin in patients with different types of atrial fibrillation（AF）,N-terminal proB-type natriuretic peptide（NT-proBNP）,and left atrial diameter （LAD）.Methods Eighty-five AF patients were divided into three groups,including 3 1 cases of paroxysmal AF （group B）,29 cases of persistent AF（group C）,and 25 cases of permanent AF（group D）while 26 inpatients without AF were enrolled as control group over the same period.For the four groups,the levels of plasma apelin and NT-proBNP were detected,LAD was measured by echocardiography,and statistical analysis was performed. Results The levels of plasma apelin in groups B,C,and D were significantly lower than that in group A（P〈0.05 for all）,and the level of group D was significantly lower than that of groups B and C（P〈0.05 for all）.The difference of levels of plasma apelin was not statistically significant between group B and group C（P〉0.05）.Com-pared with group A,the values of NT-proBNP in groups B,C,and D significantly increased（P〈0.05 for all）, and the value was the highest in group D.The difference of the value of NT-proBNP was not statistically significant between group B and group C（P〉0.05 ）.There was statistically significant difference of LAD among groups A, B,C,and D（P〈0.05 for all）,and the values increased gradually.Multiple correlation analysis revealed that the level of plasma apelin was negatively correlated with NT-proBNP and LAD（r=-0.28,-0.32,respectively;P〈0.05 for both）.Conclusion The decreased plasma apelin level was correlated with the onset and perpetuation of AF,which may be involved in atrial remodeling through anti-fibrosis mechanism.