心房颤动患者外周血淋巴细胞β_3肾上腺素受体的表达水平及临床意义

Expression and Clinical Implication of Peripheral Blood Lymphocytes β_3-adrenergic Receptor in Patients With Atrial Fibrillation

目的:检测心房颤动(房颤)患者外周血淋巴细胞β_3肾上腺素受体(β_3-AR)的表达水平,探索β_3-AR表达水平对房颤的预测价值。方法:选取经临床确诊的98例房颤患者作为房颤组(包括35例阵发性房颤患者、33例持续性房颤患者和30例永久性房颤患者),并选择31例门诊健康体检成年人作为对照组。收集两组受试者的一般临床资料及相关实验室指标。采用荧光实时定量聚合酶链式反应法检测两组受试者外周血淋巴细胞β_3-AR信使核糖核酸(mRNA)的表达量并进行比较。分析外周血淋巴细胞β_3-AR mRNA相对表达水平对房颤的预测价值。结果:房颤组β_3-AR mRNA表达水平高于对照组,相对表达水平为3.16±2.50(P<0.05)。阵发性房颤、持续性房颤和永久性房颤患者的β_3-AR mRNA相对表达水平依次为1.90±0.96、2.92±1.45、4.89±3.54,组间比较差异均有统计学意义(P均<0.05)。β_3-AR mRNA相对表达水平与左心房内径(LAD)呈正相关(r=0.256,P<0.05)。多因素Logistic回归分析显示,β_3-AR mRNA相对表达水平与房颤相关(OR=16.644,95%CI:1.106～250.503,P=0.027)。受试者工作特征曲线显示,β_3-AR mRNA相对表达水平预测房颤的曲线下面积为0.734(95%CI:0.639～0.829,P<0.05)。结论:房颤患者外周血淋巴细胞β_3-AR mRNA表达水平显著升高,β_3-AR mRNA表达水平升高可能参与心房重构。由此推断,β_3-AR mRNA表达水平可能是预测房颤的生物标志物。

Objectives: The aim of the present study was to investigate the peripheral blood lymphocytes β3-adrenergic receptor(β3-AR) expression in patients with atrial fibrillation(AF) and explore the predictive value of β3-AR expression in AF.Methods: A total of 98 patients with clinically diagnosed AF were selected as the AF group(35 patients with paroxysmal AF, 33 patients with persistent AF and 30 patients with permanent AF) and 31 healthy adults were enrolled as control group.General clinical data and related biochemical parameters were collected. The mRNA expression of β3-AR in peripheral blood lymphocytes was detected by quantitative real-time polymerase chain reaction(PCR). The predictive value of the expression level of peripheral blood lymphocytes β3-AR on AF was evaluated.Results: Compare to the control group, the relative mRNA expression level of β3-AR in AF group was 3.16±2.50(P<0.05). There were statistically significant differences on the relative mRNA expression level of β3-AR among patients with paroxysmal AF(1.90±0.96), persistent AF(2.92±1.45) and permanent AF(4.89±3.54). The mRNA expression of β3-AR increased in proportion the AF duration. Pearson correlation analysis showed that relative β3-AR mRNA expression was positively correlated with left atrial diameter(LAD) in AF group(r=0.256, P<0.05). Binary stepwise logistic regression analysis(Backward selection) showed that β3-AR is closely correlated with AF(OR=16.644,95%CI:1.106-250.503,P=0.027). Receiver operating characteristic curves showed that the area under the curve of β3-AR was 0.734 in the prediction of AF.Conclusions: Our study results suggest that β3-AR expression is significantly elevated in patients with AF and the elevated β3-AR expression may be involved in atrial structural remodeling. It can thus be inferred that β3-AR might be a potential biomarker for predicting AF.