心房颤动患者血清可溶性基质裂解素2表达水平及其与左心房重构的关系研究

Expression of Serum Souble ST-2 in Patients With Atrial Fibrillation and Its Correlation With Left Atrial Remodeling

目的探讨左心室收缩功能正常的心房颤动患者血清可溶性基质裂解素2(sST-2)水平及其与左心房重构的关系。方法选取2013年度海南省农垦总医院收治的年龄<75岁的左心室收缩功能正常的阵发性或持续性心房颤动患者86例作为试验组,另选取同期在本院体检健康,且性别和年龄与试验组相匹配者86例作为对照组。收集受试者人口学资料和临床基线资料,心脏超声测量左心室舒张末期内径、室间隔厚度,并计算左心室射血分数(LVEF)和左心房容积指数(LAVI)。采用酶联免疫吸附试验(ELISA)法检测受试者血清sST-2水平。采用单因素及多因素Logistic回归分析影响心房颤动发生的因素;采用Spearman相关分析和多元线性回归分析sST-2水平与基线资料的相关性。结果对照组和试验组性别、年龄、体质指数(BMI)、吸烟率、白细胞计数、估算肾小球滤过率(e GFR)、左心室舒张末期内径、室间隔厚度及LVEF比较,差异均无统计学意义(P>0.05);试验组LAVI和sST-2水平均高于对照组(P<0.05)。阵发性心房颤动患者病程、LAVI和sST-2水平均低于持续性心房颤动患者(P<0.05)。多因素Logistic回归分析结果显示,LAVI和sST-2水平是影响心房颤动发生的独立危险因素(P<0.05)。Spearman相关分析结果显示,心房颤动患者年龄、病程和LAVI与sST-2水平呈正相关(r=0.188、0.350、0.404,P<0.05)。多元线性回归分析结果显示,LAVI是影响心房颤动患者sST-2水平的因素(P<0.05)。结论左心室收缩功能正常的心房颤动患者血清sST-2水平明显升高,在持续性心房颤动患者中更加明显,且其是心房颤动发生的危险因素,与LAVI独立相关。

Objective To investigate the expression of serum souble ST-2（ sST-2） in atrial fibrillation（ AF）patients with normal left ventricular systolic function and its correlation with left atrial remodeling. Methods We enrolled 86 paroxysmal or persistent AF patients with normal left ventricular systolic function aged 75 who received treatment in Hainan Provincial Nongken General Hospital in 2013 as trial group,and enrolled 86 healthy matched in gender and age who received physical examination in the same period in the hospital as control group. Demographic data and clinical data of the subjects were collected. We measured left ventricular end diastolic dimension and interventricular septal thickness using cardiac uhrasonography,and calculated LVEF and LAVI. ELISA was performed to determine the serum sST-2 level of the subjects. Univariate and multivariate Logistic regression analysis were performed to identify the risk factors for AF,and Spearman correlation analysis and multiple linear regression analysis were conducted to investigate the correlation between sST-2 level and baseline data. Results Control group and trial group were not significantly different in gender,age,BMI,smoking rate,WBC,e GFR,left ventricular end diastolic dimension,interventricular septal thickness and LVEF（ P〉 0. 05）; trial group was higher than control group in LAVI and sST-2 level（ P〈 0. 05）. Paroxysmal AF patients had shorter disease course and lower LAVI and sST-2 level than persistent AF patients（ P〈 0. 05）. Multivariate Logistic regression analysis showed that LAVI and sST-2 level were risk factors for AF（ P 〈0. 05）. Spearman correlation analysis showed that age,length of disease course and LAVI had positive correlation with sST-2 level（ r = 0. 188,0. 350,0. 404, P 〈0. 05）. Multiple linear regression analysis showed that LAVI was an influencing factor for the sST-2 level of AF patients（ P 〈0. 05）. Conclusion AF patients with normal left ventricular systolic function see obvious elevation in serum sST-2 level,especially for patients with persistent AF. Serum sST-2 level is a risk factor for AF and is independently correlated with LAVI.