心房颤动病人IL-1β、Calpain-2水平与心脏结构重构的相关性研究

目的:探讨心房颤动(房颤)病人血清中白细胞介素-1β(IL-1β)、钙蛋白酶-2(Calpain-2)表达水平及与心脏结构重构的相关性。方法:选取确诊为房颤的病人150例为观察组,依据2020年ESC/EACTS房颤诊断和管理指南将其分为非阵发性房颤组和阵发性房颤组;选取同时段健康体检者120名作为对照组。分别检测血清IL-1β、Calpain-2以及超声心动图中左心室舒张期内径(LVDd)、左心房内径(LAD)、左心室射血分数(LVEF)和左心室缩短分数(FS)等指标,比较3组不同指标是否存在差异;运用Pearson相关性分析血清IL-1β、Calpain-2与超声心动图检查结果的相关性;采用二元logistic回归分析,探寻房颤的危险因素。结果:观察组中IL-1β、Calpain-2含量显著高于对照组(P<0.05),而且非阵发性房颤病人明显高于阵发性房颤病人(P<0.05)。在超声心动图指标中非阵发性房颤组LAD、LVDd均高于阵发性房颤组以及对照组(P<0.05),LVEF、FS均低于阵发性房颤组及对照组(P<0.05)。二元logistic回归分析显示IL-1β、Calpain-2是房颤发生的危险因素。Spearman相关性分析显示IL-1β、Calpain-2与LAD、LVDd呈正相关关系(P<0.01),而与LVEF、FS呈显著负相关关系(P<0.01)。结论:IL-1β、Calpain-2与LAD、LVDd呈正相关关系,参与了心脏结构重构过程,进而促进了房颤的发生与发展。

具有精确幅值积分特性的正交信号发生器

针对二阶广义积分器(SOGI)在快速瞬态响应的情况下幅值积分过程不理想、参数设计困难的问题,提出一种具有精确幅值积分特性的正交信号发生器。首先,从一阶系统(FOS)的角度分析SOGI-QSG的动态响应。其次,对广义正交积分器(GI-QSG)的动态响应存在的问题做进一步分析。结果表明,SOGI-QSG的时域响应不仅与增益有关,还受到输入信号参数的影响。为解决此问题,提出基于精确幅值积分器的正交信号发生器(AMI-QSG),与SOGI相比,AMI对正弦信号具有更优异的幅值积分性能,并且其幅值响应更接近FOS,因此其参数设计可以参考FOS,使参数设计更加简单。此外,还可以方便地调整AMI-QSG的结构来抑制直流分量和提取谐波分量。最后通过仿真和实验验证了理论分析的正确性和所提方法的优越性。

血清ICAM⁃1和LDH活性水平在冠心病不同严重程度血管病变中的变化

目的:分析患者血清细胞中的黏附活性因子1(cell adhesion factor⁃1,ICAM⁃1)以及血清乳酸脱氢酶(Lactatedehydrogenase,LDH)活性因子水平与冠心病(coronary heart disease,CHD)不同类型冠脉狭窄程度之间的相关性,探讨其在CHD病情进展中的作用。方法:选择因胸痛入院并行冠状动脉造影检查的病人180例,其中冠状动脉造影明确诊断为CHD的病人145例,冠状动脉造影无异常为对照病人35例(对照组)。145例CHD患者根据不同的冠状动脉和心血管扩张分支的狭窄部分和程度进一步细分为轻度狭窄部分程度组(a⁃CHD,狭窄程度发展进程≤49%,n=25)、中度狭窄组(b⁃CHD,狭窄程度发展进程50%~74%,n=46)和严重狭窄部分程度组(c⁃CHD,狭窄程度发展进程≥75%,n=74)。通过ELISA检测患者血清中ICAM⁃1和LDH活性水平,统计分析在不同冠状动脉病变程度下以及对照组ICAM⁃1和LDH活性差异。结果:a⁃CHD组、b⁃CHD组和c⁃CHD组中ICAM⁃1、LDH水平和Gensini评分均较对照组增高,差异有统计学意义(P<0.05)。ICAM⁃1、LDH水平和Gensini评分随不同冠状动脉狭窄进程的加剧而逐渐增加,差异有统计学意义(P<0.05)。随着CHD病变支数的增多血清ICAM⁃1和LDH水平显著增高,差异有统计学意义(P<0.01)。ICAM⁃1和LDH水平与Gensini评分呈正相关(LDH:r=0.409,P<0.01;ICAM⁃1:r=0.463,P<0.01),ICAM⁃1与中性粒细胞计数正相关(r=0.208,P<0.01),LDH和ICAM⁃1水平与HDL呈负相关(LDH:r=−0.184,P<0.05;ICAM⁃1:r=−0.175,P<0.05),LDH与总蛋白呈负相关(r=−0.218,P<0.01),ICAM⁃1与LDH呈正相关(r=0.441,P<0.01)。结论:随着不同冠状动脉狭窄进程的加剧,血清ICAM⁃1与LDH水平逐渐升高,且两者之间存在相关性。

心房颤动患者血清转化生长因子β2及半乳糖凝集素-2的表达及临床意义

目的:探讨血清转化生长因子β2(TGF-β2)及半乳糖凝集素-2(Galectin-2)在心房颤动患者中的表达情况及临床意义。方法:选取2019年1~6月蚌埠医学院第一附属医院心内科住院患者150例,其中阵发性心房颤动组84例,持续性心房颤动组66例,以及同时期入院检查排除心房颤动的窦性心律患者120例作为对照组,入院后完善血常规、生化常规以及心脏超声形态学检查。另外,采用ELISA法及Western Blot检测各组受试者血清及外周血单个核细胞(PBMC)中TGF-β2和Galectin-2水平,分析两者在不同分组间的差异及临床意义;应用Pearson相关性分析进一步检验TGF-β2、Galectin-2与左心房舒张末期内径(LAD)的相关性;通过二元Logistics回归分析的方式,得出影响心房颤动的因素。结果:与对照组相比,心房颤动组患者年龄及LAD明显升高,差异具有统计学意义(P<0.05);持续性房颤组患者血清中TGF-β2和Galectin-2浓度相较于阵发性房颤组及对照组均明显增高,差异具有统计学意义(P<0.05),对照组相较于阵发性房颤组明显下降,差异具有统计学意义(P<0.05);Pearson相关性分析显示在实验组中TGF-β2和Galectin-2浓度与LAD大小呈正相关(P<0.05);二元logistics回归分析显示TGF-β2、Galectin-2、LAD是房颤的危险因素(P<0.05)。结论:TGF-β2、Galectin-2与房颤的发生、发展有着密切关系。TGF-β2与Galectin-2之间且二者与LAD间均呈正相关,三者在房颤患者心房炎性纤维化的发生与进展中具有协同作用,共同促进心房的机械重构及电重构,并可作为评估房颤发生发展的危险因素。

Expression and clinical significance of serum galactose lectin-2 and transforming growth factor-β2 in patients with atrial fibrillation

Objective:To investigate the expression of serum transforming growth factorβ2(TGF-β2)and galectin-2(Galectin-2)in patients with atrial fibrillation and its clinical significance.Methods:A total of 150 inpatients in the Department of Cardiology of the First Affiliated Hospital of Bengbu Medical College from January 2019 to June 2019 were selected,including 84 patients in the paroxysmal atrial fibrillation group,66 patients in the persistent atrial fibrillation group,and 120 patients with sinus rhythm excluding atrial fibrillation who were hospitalized during the same period were selected as the control group.Blood routine,biochemical routine and cardiac ultrasonic morphological examination were improved after admission.In addition,the serum levels of TGF-β2 and Galectin-2 in each group were detected by Elisa and Western Blot,and the differences and clinical significance of TGF-β2 and Galectin-2 in different groups were statistically analyzed.The correlation between TGF-β2,Galectin-2 and left atrial end-diastolic diameter(LAD)was further determined by Pearson correlation analysis.By means of binary logistics regression analysis,the factors affecting atrial fibrillation were obtained.Results:Compared with the control group,age and LAD in atrial fibrillation group were significantly increased(P<0.05).The serum concentrations of TGF-β2 and galectin-2 in persistent af group were significantly increased compared with those in paroxysmal af group and control group(P<0.05),while those in control group were significantly decreased compared with paroxysmal AF group(P<0.05).Pearson correlation analysis showed that TGF-β2 and Galectin-2 concentrations were significantly positively correlated with LAD size in the experimental group(P<0.05).Binary logistic regression analysis showed that TGF-β2,galectin-2 and LAD were risk factors for atrial fibrillation(P<0.05).Conclusion:TGF-β2 and Galectin-2 are closely related to the occurrence and development of atrial fibrillation.Both TGF-β2 and Galectin-2 were positively correlated with LAD.The three have a synergistic effect on the occurrence and progression of atrial inflammatory fibrosis in patients with ATRIAL fibrillation,jointly promoting mechanical and electrical remodeling of atrial,and can be used as risk factors to evaluate the occurrence and progression of atrial fibrillation.