血清胱抑素C水平与慢性房颤的相关性研究

发布时间：2018-04-14 17:31

本文选题：胱抑素C + 房颤　；参考：《吉林大学》2017年硕士论文

【摘要】：目的:研究血清Cys-C水平与慢性心房颤动及其临床分型的相关性。方法:连续入选2013年9月至2016年11月在吉林大学白求恩第一医院就诊的患者278例为研究对象,将其分为房颤组182例,无房颤对照组96例。其中房颤组根据欧洲房颤管理指南、北美起搏和电生理学会的心律失常工作组联合组织对房颤的分类,分为阵发性房颤(paroxysmal Af)组、持续性房颤(pesistent Af)组、永久性房颤(permanent Af)组。结果:(1)房颤组胱抑素C水平明显高于对照组,差异有统计学意义(p0.001);不同房颤类型患者的Cys-C水平比较:永久性房颤组高于持续性房颤组,持续性房颤组高于阵发性房颤组,差异均有统计学意义(p0.001)。(2)胱抑素C水平与其他指标的相关性分析结果:在房颤组中胱抑素C水平与白细胞计数、中性粒细胞百分比、CRP水平、同型半胱氨酸水平、左心房内径呈线性正相关,相关系数分别为(r=0.211,p=0.004)、(r=0.184,p=0.013)、(r=0.269,p0.001)、(r=0.424,p0.001)、(r=0.269,p0.001);与年龄、中性粒细胞绝对值、钙离子浓度和左心室内径间无相关性(p0.05)。(3)房颤组左心室内径、左心房内径、中性粒细胞百分比、低密度脂蛋白胆固醇、C反应蛋白、同型半胱氨酸水平均高于对照组,差异有统计学意义(p0.05);左室射血分数小于对照组,差异有统计学意义(p0.001)。(4)不同房颤类型组间的左室射血分数、左心房内径、中性粒细胞百分比、低密度脂蛋白胆固醇、C反应蛋白、同型半胱氨酸水平间的差异均有统计学意义(p0.05)。对于中性粒细胞百分比,永久性房颤(Permanent Af)组高于阵发性房颤组(paroxysmal Af),差异有统计学意(p0.05)。对于低密度脂蛋白胆固醇,永久性房颤(Permanent Af)组高于阵发性房颤(paroxysmal Af)组和持续性房颤(persistent Af)组,差异有统计学意义(p0.05)。对于左室射血分数,永久性房颤(Permanent Af)组低于阵发性房颤(paroxysmal Af)组和持续性房颤(persistent Af)组,差异有统计学意义(p0.05)。在左心房内径、C反应蛋白、同型半胱氨酸水平上永久性房颤(Permanent Af)组高于持续性房颤(persistent Af)组,持续性房颤(persistent Af)组高于阵发性房颤(paroxysmal Af)组,差异均有统计学意义(p0.05)。(5)房颤危险因素的多元logistic回归分析:结果显示C反应蛋白、同型半胱氨酸、胱抑素C水平、左心室内径大小、左心房内径大小为影响房颤的危险因素。结论:1、血清胱抑素C水平在房颤组明显高于对照组,在不同房颤临床分型之间有差异,其水平随房颤持续时间的增加而增加。2、血清胱抑素C水平与炎性标志物CRP、白细胞、中性粒细胞百分比水平呈正相关,表明血清胱抑素C与机体的慢性炎症有关,参与房颤的发生、维持和复发。3、Logistic分析结果提示在校正了其他因素影响,血清胱抑素C水平升高可以作为房颤的独立预测因子。
[Abstract]:Objective: to study the correlation between serum Cys-C level and chronic atrial fibrillation.Methods: two hundred and eighty-eight consecutive patients from September 2013 to November 2016 in Bai Qiuen first Hospital of Jilin University were selected and divided into two groups: the atrial fibrillation group (n = 182) and the control group (n = 96).The atrial fibrillation group was divided into three groups according to the European atrial fibrillation management guidelines, the atrial fibrillation group organized by the pacing and electrophysiological association of North America, the paroxysmal Afgroup, the persistent atrial fibrillation persistent Afar group and the permanent atrial fibrillation permanent Af. group.Results the level of cystatin C in the atrial fibrillation group was significantly higher than that in the control group, the difference was statistically significant (p 0.001). The Cys-C level of the patients with different types of atrial fibrillation was higher than that of the persistent atrial fibrillation group, and that of the persistent atrial fibrillation group was higher than that of the paroxysmal atrial fibrillation group.The correlation between the level of cystatin C and other indexes: in atrial fibrillation group, the level of cystatin C and white blood cell count, percentage of neutrophils and CRP, homocysteine level were analyzed.The levels of low density lipoprotein cholesterol C reactive protein and homocysteine were significantly higher than those of the control group (P 0.05), and the left ventricular ejection fraction (LVEF) was lower than that of the control group (P 0.001), and the left ventricular ejection fraction (LVEF) of different atrial fibrillation groups was significantly lower than that of the control group (P < 0.05).There were significant differences in left atrial diameter, percentage of neutrophils, low density lipoprotein cholesterol C-reactive protein and homocysteine levels.The percentage of neutrophils in permanent atrial fibrillation patients was higher than that in paroxysmal Afs patients with paroxysmal atrial fibrillation (P 0.05).For low density lipoprotein cholesterol, there was a significant difference between permanent AF and paroxysmal Afs and persistent AF persistent Af.For left ventricular ejection fraction (LVEF), the difference was statistically significant in permanent AF Af1 group, paroxysmal AF group and persistent AF persistent Af1 group (P 0.05).At the level of homocysteine, permanent atrial fibrillation (permanent) was higher than persistent atrial fibrillation (persistent), persistent atrial fibrillation (persistent) was higher than paroxysmal Afar (P < 0.05).Multivariate logistic regression analysis showed that C-reactive protein, homocysteine, cystatin C, left ventricular diameter and left atrial diameter were the risk factors of atrial fibrillation.Conclusion: the serum cystatin C level in the AF group was significantly higher than that in the control group, and there was a difference between the clinical types of AF and the clinical type of AF. The serum cystatin C level and the inflammatory marker CRP, leukocyte were increased with the increase of AF duration, and the serum cystatin C level was significantly higher in the AF group than that in the control group.The percentage of neutrophils was positively correlated, indicating that serum cystatin C was associated with chronic inflammation, and was involved in the occurrence, maintenance and recurrence of atrial fibrillation.Elevated serum cystatin C level may be an independent predictor of atrial fibrillation.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.75

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