房颤患者中性粒细胞CD11b变化及与左房内径的相关性

PMN-CD11b Levels and Its Correlation with Left Atrial Diameter in Patients with Atrial Fibrillation

【目的】研究房颤患者外周血中性粒细胞CD11b水平变化及其与左房内径的相关性,探讨房颤的炎症机制。【方法】收集房颤组与窦律组临床资料,采血检测中性粒细胞CD11b表达水平,同时超声心动图测定左房内径。【结果】纳入房颤组85例,年龄37~82岁,男性35例,女性50例,包括阵发性房颤36例,持续性房颤26例,永久性房颤23例;窦律组57例,年龄35~78岁,男性21例,女性36例。房颤组中性粒细胞CD11b表达高于窦律组(P<0.01);左房内径大于窦律组(P<0.01);心脏瓣膜病、中性粒细胞CD11b及左房内径是房颤的独立影响因素。【结论】阵发性房颤发作时及持续性、永久性房颤患者中性粒细胞CD11b表达上调,提示炎症与房颤密切相关;中性粒细胞CD11b水平与左房内径相关,炎症可能参与了房颤的心房结构重构;房颤血栓栓塞高危患者中性粒细胞CD11b表达上调,炎症水平可能对房颤血栓栓塞危险分层有一定指导意义。

【Objective】To observe the levels of CD11b expressions in the surface of neutrophils in serum,and its correlation with left atrial diameter,and to study the inflammatory mechanisms in atrial fibrillation(AF)patients.【Methods】Clinical characteristics and blood samples of AF group and sinal rhythm group were collected.CD11b levels in the surface of neutrophils were examined by flow cytometry.Left atrial diameter was examined by echocardiography.【Results】The AF group included 85 patients:36 with paroxysmal AF;26 with persistent AF;23 with permanent AF.The sinal rhythm group includes 57 patients.PMN-CD11b levels were significantly higher in Af group than in sinal rhythm group(P<0.01).The left atrial diameter was larger in AF group than in sinal rhythm group(P<0.01).Multivariate analysis revealed that PMN-CD11b,left atrial diameter and Valvular heart disease were independent predictors of atrial fibrillation.【Conclusions】PMN-CD11b levels were elevated in paroxysmal AF when AF was present and in persistent,permanent AF patients,implying atrial fibrillation was closely related to inflammation;PMN-CD11b were correlated with left atrial diameter,inflammation might participate in the atrial structural remodeling in AF patients;PMN-CD11b levels were elevated in AF patients with high risk thrombosis,inflammation might have some value to embolic risk stratification according to CHA2DS2-VASc score.