葡萄糖调节蛋白94和转化生长因子-β1与房颤患者预后的相关性

Relativity between glucose-regulated protein 94,transforming growth factor-β1 and prognosis of patients with atrial fibrillation

目的探讨葡萄糖调节蛋白94(glucose-regulated protein 94,GRP94)、转化生长因子-β1(transforming growth factor-β1,TGF-β1)水平对房颤患者消融术后远期复发事件的预测价值。方法选择因房颤行射频消融术的住院患者共202例,统一归于房颤组,再依据房颤发生及持续的时间进一步分为阵发性房颤组(n=132)和持续性房颤组(n=70);另选择窦性心律且既往无房颤心律的健康体检者作为对照组(n=55)。通过酶联免疫吸附试验测定患者的血清GRP94及TGF-β1水平,并收集基线资料。出院后以门诊或电话形式对房颤患者进行随访,利用受试者工作特征曲线和Kaplan-Meier生存分析评估血清GRP94、TGF-β1水平对房颤患者消融术后远期复发事件的预测价值。结果在对照组、阵发性房颤组、持续性房颤组中,血清GRP94及TGF-β1水平依次升高。二元Logistic回归分析提示,血清TGF-β1、GRP94和体重指数是房颤发生的独立危险因素。Spearman相关性分析显示,在房颤患者血清中GRP94和TGF-β1水平呈正相关。复发组的TGF-β1高于非复发组,GRP94低于非复发组。二元Logistic回归分析表明,TGF-β1是房颤术后复发的独立危险因素,GRP94是房颤复发的独立保护因素。Kaplan-Meier曲线分析显示,GRP94高水平、TGF-β1低水平的房颤患者消融术后复发的风险低,且未复发时间更长。结论GRP94及TGF-β1水平与房颤密切相关,可能为房颤患者消融术后复发的早期识别、诊断及预防提供依据。

Objective To explore the predictive value of glucose-regulated protein 94(GRP94)and transforming growth factor-β1(TGF-β1)levels for long-term recurrence events in patients with atrial fibrillation(AF)after ablation.Methods A total of 202 inpatients undergoing radiofrequency ablation for AF were selected and uniformly attributed to AF group.They were further divided into paroxysmal AF group(n=132)and persistent AF group(n=70)according to the occurrence time and duration of AF.Healthy subjects with sinus rhythm and previously without AF rhythm were selected as control group(n=55).Serum GRP94 and TGF-β1 levels were measured by enzyme linked immunosorbent assay and the enrolled patients’baseline data were collected.After discharge,patients with AF were followed up in the outpatient department or by telephone.Receiver operating characteristic curve and Kaplan-Meier survival analysis were used to evaluate the value of serum GRP94 and TGF-β1 levels in predicting long-term recurrence events in AF patients after ablation.Results Serum GRP94 and TGF-β1 levels of the control group,paroxysmal AF group and persistent AF group increase in turn.Binary Logistic regression analysis suggests that serum TGF-β1,GRP94 and body mass index are independent risk factors for AF.Spearman correlation analysis shows a positive correlation between serum GRP94 and TGF-β1 levels in AF patients.The TGF-β1 level of the recurrence group is higher than that of the non-recurrence group while the GRP94 level of the recurrence group is lower than that of the non-recurrence group.Binary Logistic regression analysis shows that TGF-β1 is an independent risk factor for postoperative recurrence of AF while GRP94 is an independent protective factor.Analysis of Kaplan-Meier curve shows that AF patients with high GRP94 level and low TGF-β1 level have a lower risk of recurrence after ablation,and longer duration without recurrence.Conclusion GRP94 and TGF-β1 levels are closely related to AF,which probably provides references for the early identification,diagnosis and prevention of recurrent AF after operation.