活化转录因子4在心房颤动患者血浆和外周血单核细胞中的表达及与预后的相关性

The expression of ATF4 in plasma and peripheral blood mononuclear cells of patients with atrial fibrillation and its correlation with clinical prognosis

目的:研究活化转录因子4(ATF4)在心房颤动(AF)患者中的表达,并探讨血浆ATF4对接受射频消融术的AF患者术后复发的预测价值。方法:选取2019年2月—2020年2月于蚌埠医学院第一附属医院首次接受射频消融术治疗的AF患者149例,其中阵发性房颤组(PaAF组)83例,持续性房颤组(PeAF组)66例,并选取同期至我院体检患者120例为对照组,应用ELISA法检测血浆ATF4的表达水平;Western blot法检测外周血单核细胞(PBMCs)中ATF4蛋白的表达水平,对两组患者术后进行平均(12±1)个月的随访,绘制ROC曲线分析ATF4在AF复发中的预测价值。结果:PeAF组和PaAF组血浆和PBMCs中ATF4水平明显高于对照组(P<0.01),但PeAF组与PaAF组之间无显著差异。与AF患者术后未复发组相比,复发组患者血浆ATF4水平显著升高,两组差异具有统计学意义[(418.26±126.02):(392.42±117.65),F=39.53,P<0.01]。血浆ATF4水平预测术后复发的曲线下面积为0.769。结论:AF患者血浆和PBMCs中ATF4水平升高,对术后复发具有预测价值。

Objective: To explore the relationship between activated transcription factor 4(ATF4) and atrial fibrillation(AF), and to study the predictive value of plasma ATF4 for postoperative recurrence in AF patients undergoing radiofrequency ablation. Methods: The 149 patients with AF who received radiofrequency ablation for the first time in the First Affiliated Hospital of Bengbu Medical College from February 2019 to February 2020 were selected. Among them, 83 patients in the paroxysmal atrial fibrillation group(PaAF group) and 66 cases in persistent atrial fibrillation Group(PeAF group), and selected 120 patients in our hospital for physical examination during the same period as the control group. We used enzyme-linked immunosorbent assay(ELISA method) to detect the expression level of plasma ATF4;Western blot method to detect peripheral blood. The expression level of ATF4 protein in monocytes(PBMCs) was detected. ROC curve was analyzed the predictive value of ATF4 in AF recurrence following up for(12±1) months. Results: The levels of plasma ATF4 in the PeAF and PaAF groups were significantly higher than those in the control group(P<0.01), but there was no significant difference between the PeAF and PaAF groups. The plasma ATF4 level in the recurring group was significantly higher compared with the non-recurring group[(418.26±126.02):(392.42±117.65), F=39.53, P<0.01]. ROC curve results show that the plasma ATF4 levels predict postoperative recurrence area under the curve(AUC) 0.769. Conclusion: The levels of ATF4 in plasma and PBMCs are elevated, which have predictive values for postoperative recurrence of AF patients.