心房颤动患者同型半胱氨酸、胱抑素C与颈动脉粥样硬化、左心房内径的相关性研究

Correlation of Homocystine and Cystatin C with Carotid Atherosclerosis and Left Atrial Diameter in Patients with Atrial Fibrillation

目的研究非瓣膜性心房颤动(简称房颤)患者血清同型半胱氨酸(Hcy)和胱抑素C(Cys-C)水平的变化及与左心房内径和颈动脉粥样硬化水平的相关性,探讨炎症、氧化反应在非瓣膜性房颤的发生、发展中的变化及意义。方法选择房颤患者(房颤组)52例,窦性心律患者(对照组)20例,其中房颤组又分为阵发性房颤组18例和永久性房颤组34例。检测各组Hcy、Cys-C水平;颈动脉超声检测颈动脉内膜中层厚度(IMT),评价颈动脉粥样硬化情况;心脏彩超检测左心房内径(LAD)及左心室内径(LVD)。结果与对照组比较,阵发性房颤组、永久性房颤组Hcy、Cys-C、IMT及LAD明显升高(P<0.05),永久性房颤组较阵发性房颤组升高的更加明显(P<0.05),Cys-C和Hcy水平与左房内径大小呈正相关(P<0.05)。结论炎症和氧化反应在非瓣膜性房颤患者颈动脉粥样硬化的发生、发展,LAD变化中可能起重要作用,而且与房颤的持续时间有关,Hcy、Cys-C与房颤的发生、发展及颈动脉粥样硬化、LAD的变化程度密切相关。

Objective To investigate the levels of homocystine(Hcy)and cystatin C(Cys-C)and their correlation with the left atrial diameter(LAD)and the severity of carotid atherosclerosis in patients with non-valvular atrial fibrillation(AF),and to explore the significance of inflammatory reaction and oxidation reaction in the occurrence and development of non-valvular AF.Methods 52 patients with AF were assigned into AF group.20 patients with sinus rhythm were assigned into the control group.AF group was subdivided into paroxysmal AF group(18 cases)and permanent AF group(34 cases).The levels of Hcy and Cys-C were tested.Carotid artery ultrasound was used to detect carotid atherosclerosis by measuring carotid intima media thickness(IMT).LAD and left ventricular diameter(LVD)were measured by color Doppler echocardiography.Results The levels of Hcy,Cys-C,IMT and LAD were significantly higher in paroxysmal AF group and permanent AF group than those in control group(P<0.05),and were higher in permanent AF group than those in paroxysmal AF group(P<0.05).The levels of Hcy and Cys-C were positively correlated with LAD(P<0.05).Conclusion Inflammatory reaction and oxidation reaction may play an important role in the occurrence and progress of carotid atherosclerosis and the enlargement of LAD,and are associated with the duration of AF in the patients with non-valvular AF.The levels of Hcy and Cys-C are closely related with the severity of carotid atherosclerosis and the enlargement of LAD in the patients with non-valvular AF.