半乳糖凝集素-3、同型半胱氨酸及超敏C反应蛋白与心房颤动左心房结构重构关系的探讨
发布时间：2018-07-25 07:07
【摘要】：目的:通过探讨半乳糖凝集素-3、超敏C反应蛋白以及同型半胱氨酸跟左心房容积指数的相关性,来研究它们在左心房结构重构和房颤发生发展过程中作用,进一步增进对房颤发生发展机制及危险因素的认识,为临床房颤的预防与治疗提供更多的思路。方法:选取2013年09月至2014年09月在南昌大学第二附属医院心血管内科住院房颤病人107例(男51例,女56例),年龄(65.2±8.6)岁。其中持续性房颤(61例),阵发性房颤(46例)。同时选取40例基本资料与房颤组相类似的窦性心律者作为对照组。所有患者入院后收集一般资料,包括:性别、年龄、身高、体重等。入院后次日清晨空腹抽外周血查肝肾功能、血糖、血脂、甲状腺功能等常规实验室检查,进行床边心电图、24小时动态心电图检查。心脏彩超检查记录左心房内径、左室射血分数等指标,运用心脏彩超测量并计算出左心房容积指数。ELISA法检测半乳糖凝集素-3及同型半胱氨酸水平,免疫比浊法检测超敏C反应蛋白水平。根据房颤类型分组(持续性房颤组、阵发性房颤组)及对照组进行分析,比较三组间半乳糖凝集素-3、同型半胱氨酸、超敏C反应蛋白的差异,Pearson分析半乳糖凝集素-3、同型半胱氨酸、超敏C反应蛋白水平跟左心房容积指数的关系,对左心房容积指数行多因素线性回归分析,对房颤危险因素进行多因素Logistic回归分析。结果:1、持续性房颤组血清半乳糖凝集素-3水平(1567.1±185.3 pg/ml)显著高于阵发性房颤组(1482.5±107.3 pg/ml)及对照组(1389.4±121.2 pg/ml)(P0.05),且阵发性房颤组高于对照组(P0.05);持续性房颤组超敏C反应蛋白水平(3.85±3.01mg/L)显著高于阵发性房颤组(2.84±2.21mg/L)及对照组(1.71±1.40mg/L)(P0.05),且阵发性房颤组高于对照组(P0.05);持续性房颤组同型半胱氨酸水平(12.12±4.40μmol/L)高于阵发性房颤组(10.31±3.41μmol/L)及对照组(8.36±2.91μmol/L)(P0.05),且阵发性房颤组高于对照组(P0.05);2、持续性房颤组左心房容积指数(40.90±7.87ml/m2)显著大于阵发性房颤组(35.48±7.20ml/m2)及对照组(31.39±4.51ml/m2)(P0.05),且阵发性房颤组大于对照组(P0.05);Pearson相关性分析显示:左心房容积指数与半乳糖凝集素-3(r=0.618,P0.01)、超敏C反应蛋白(r=0.602,P0.01)、同型半胱氨酸(r=0.348,P0.01)呈正相关。多元线性回归分析结果显示:左心房容积指数与左房内径、血清半乳糖凝集素-3水平、外周血超敏C反应蛋白水平以及心房颤动呈线性相关;3、多因素Logistic回归分析结果显示:半乳糖凝集素-3、超敏C反应蛋白、年龄及左心房容积指数是心房颤动的发生的危险因素。结论:1、持续性及阵发性房颤患者半乳糖凝集素-3、同型半胱氨酸及超敏C反应蛋白水平均高于窦性心律者,且持续性房颤高于阵发性房颤;2、房颤患者半乳糖凝集素-3及超敏C反应蛋白与左心房容积指数呈线性相关,提示心房纤维化及炎症反应参与了左心房结构重构,在房颤的发生、发展与维持过程中起重要作用;3、房颤患者同型半胱氨酸与左心房容积指数呈正相关,氧化应激可能参与了左心房结构重构。
[Abstract]:Objective: To study the correlation between galactose agglutinin -3, hypersensitive C reactive protein and homocysteine and left atrial volume index, to study their role in the remodeling of left atrium and the development of atrial fibrillation, and to further enhance the understanding of the mechanism and risk factors of atrial fibrillation, and to prevent and treat clinical atrial fibrillation. Methods: 107 patients (51 men, 56 women), aged (65.2 + 8.6) years of age (61 cases) and paroxysmal atrial fibrillation (46 cases), were selected from 09 months to 09 months in the Second Affiliated Hospital of Nanchang University from 2013 to 09 months in the Department of cardiovascular medicine, the second Affiliated Hospital of Nanchang University. Control group. All the patients were admitted to the hospital after admission, including sex, age, height, weight and so on. After the next day, the liver and kidney function, blood sugar, blood lipid and thyroid function were examined on the next morning, and the bedside electrocardiogram and 24 hour dynamic electrocardiogram were performed. The left atrium diameter and left ventricular ejection were recorded by echocardiography. The blood fraction and other indexes were measured by echocardiography and the left atrial volume index (.ELISA) was used to detect the level of galactose agglutinin -3 and homocysteine. Immunoturbidimetry was used to detect the level of hypersensitive C reaction protein. The three groups of galactose were compared according to the group of atrial fibrillation type (persistent atrial fibrillation group, paroxysmal atrial fibrillation group) and control group. The difference of lectin -3, homocysteine, hypersensitive C reactive protein, Pearson analysis of the relationship between galactose lectin -3, homocysteine, hypersensitivity C reaction protein and left atrial volume index, multiple factor linear regression analysis of left atrial volume index, multiple factor Logistic regression analysis on risk factors for atrial fibrillation. Results: 1, continuous The level of serum galactoagglutinin -3 (1567.1 + 185.3 pg/ml) in sexual atrial fibrillation group was significantly higher than that in paroxysmal atrial fibrillation group (1482.5 + 107.3 pg/ml) and control group (1389.4 + 121.2 pg/ml) (P0.05), and paroxysmal atrial fibrillation group was higher than that of control group (P0.05). The level of hypersensitive C reverse protein (3.85 + 3.01mg/L) in persistent atrial fibrillation group was significantly higher than that in paroxysmal atrial fibrillation group (2.84 + 2.). 21mg/L) and the control group (1.71 + 1.40mg/L) (P0.05), and paroxysmal atrial fibrillation group was higher than the control group (P0.05); the level of homocysteine in the persistent atrial fibrillation group (12.12 + 4.40 mu mol/L) was higher than that of paroxysmal atrial fibrillation group (10.31 + 3.41 micron mol/L) and control group (8.36 + 2.91 mol/L) (P0.05), and paroxysmal atrial fibrillation group was higher than the control group (P0.05); 2, left atrial fibrillation group left Atrial volume index (40.90 + 7.87ml/m2) was significantly greater than that in paroxysmal atrial fibrillation group (35.48 + 7.20ml/m2) and control group (31.39 + 4.51ml/m2) (P0.05), and paroxysmal atrial fibrillation group was larger than control group (P0.05); Pearson correlation analysis showed that the left atrium volume index and galactose agglutinin -3 (r=0.618, P0.01), hypersensitive C reactive protein (r=0.602, P0.01), homotypic half R=0.348 (P0.01) showed positive correlation. Multivariate linear regression analysis showed that the left atrium volume index was linearly related to the left atrial diameter, serum galactose -3 level, peripheral blood hypersensitivity C reaction protein level and atrial fibrillation; 3, multifactor Logistic regression analysis showed that galactose agglutinin -3, hypersensitive C reactive protein, Age and left atrial volume index were risk factors for atrial fibrillation. Conclusion: 1, the levels of galactose -3, homocysteine and hypersensitivity C reaction protein in patients with persistent and paroxysmal atrial fibrillation are higher than those in sinus rhythm, and persistent atrial fibrillation is higher than paroxysmal atrial fibrillation; 2, atrial fibrillation patients with galactose agglutinin -3 and hypersensitive C reaction eggs There is a linear correlation between white and left atrial volume index, suggesting that atrial fibrosis and inflammatory reactions participate in the remodeling of the left atrium, and play an important role in the occurrence, development and maintenance of atrial fibrillation. 3, the homocysteine of atrial fibrillation is positively correlated with the left atrium volume index, and oxygen stress may be involved in the remodeling of the left atrium.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R541.75
本文编号：2143029
[Abstract]:Objective: To study the correlation between galactose agglutinin -3, hypersensitive C reactive protein and homocysteine and left atrial volume index, to study their role in the remodeling of left atrium and the development of atrial fibrillation, and to further enhance the understanding of the mechanism and risk factors of atrial fibrillation, and to prevent and treat clinical atrial fibrillation. Methods: 107 patients (51 men, 56 women), aged (65.2 + 8.6) years of age (61 cases) and paroxysmal atrial fibrillation (46 cases), were selected from 09 months to 09 months in the Second Affiliated Hospital of Nanchang University from 2013 to 09 months in the Department of cardiovascular medicine, the second Affiliated Hospital of Nanchang University. Control group. All the patients were admitted to the hospital after admission, including sex, age, height, weight and so on. After the next day, the liver and kidney function, blood sugar, blood lipid and thyroid function were examined on the next morning, and the bedside electrocardiogram and 24 hour dynamic electrocardiogram were performed. The left atrium diameter and left ventricular ejection were recorded by echocardiography. The blood fraction and other indexes were measured by echocardiography and the left atrial volume index (.ELISA) was used to detect the level of galactose agglutinin -3 and homocysteine. Immunoturbidimetry was used to detect the level of hypersensitive C reaction protein. The three groups of galactose were compared according to the group of atrial fibrillation type (persistent atrial fibrillation group, paroxysmal atrial fibrillation group) and control group. The difference of lectin -3, homocysteine, hypersensitive C reactive protein, Pearson analysis of the relationship between galactose lectin -3, homocysteine, hypersensitivity C reaction protein and left atrial volume index, multiple factor linear regression analysis of left atrial volume index, multiple factor Logistic regression analysis on risk factors for atrial fibrillation. Results: 1, continuous The level of serum galactoagglutinin -3 (1567.1 + 185.3 pg/ml) in sexual atrial fibrillation group was significantly higher than that in paroxysmal atrial fibrillation group (1482.5 + 107.3 pg/ml) and control group (1389.4 + 121.2 pg/ml) (P0.05), and paroxysmal atrial fibrillation group was higher than that of control group (P0.05). The level of hypersensitive C reverse protein (3.85 + 3.01mg/L) in persistent atrial fibrillation group was significantly higher than that in paroxysmal atrial fibrillation group (2.84 + 2.). 21mg/L) and the control group (1.71 + 1.40mg/L) (P0.05), and paroxysmal atrial fibrillation group was higher than the control group (P0.05); the level of homocysteine in the persistent atrial fibrillation group (12.12 + 4.40 mu mol/L) was higher than that of paroxysmal atrial fibrillation group (10.31 + 3.41 micron mol/L) and control group (8.36 + 2.91 mol/L) (P0.05), and paroxysmal atrial fibrillation group was higher than the control group (P0.05); 2, left atrial fibrillation group left Atrial volume index (40.90 + 7.87ml/m2) was significantly greater than that in paroxysmal atrial fibrillation group (35.48 + 7.20ml/m2) and control group (31.39 + 4.51ml/m2) (P0.05), and paroxysmal atrial fibrillation group was larger than control group (P0.05); Pearson correlation analysis showed that the left atrium volume index and galactose agglutinin -3 (r=0.618, P0.01), hypersensitive C reactive protein (r=0.602, P0.01), homotypic half R=0.348 (P0.01) showed positive correlation. Multivariate linear regression analysis showed that the left atrium volume index was linearly related to the left atrial diameter, serum galactose -3 level, peripheral blood hypersensitivity C reaction protein level and atrial fibrillation; 3, multifactor Logistic regression analysis showed that galactose agglutinin -3, hypersensitive C reactive protein, Age and left atrial volume index were risk factors for atrial fibrillation. Conclusion: 1, the levels of galactose -3, homocysteine and hypersensitivity C reaction protein in patients with persistent and paroxysmal atrial fibrillation are higher than those in sinus rhythm, and persistent atrial fibrillation is higher than paroxysmal atrial fibrillation; 2, atrial fibrillation patients with galactose agglutinin -3 and hypersensitive C reaction eggs There is a linear correlation between white and left atrial volume index, suggesting that atrial fibrosis and inflammatory reactions participate in the remodeling of the left atrium, and play an important role in the occurrence, development and maintenance of atrial fibrillation. 3, the homocysteine of atrial fibrillation is positively correlated with the left atrium volume index, and oxygen stress may be involved in the remodeling of the left atrium.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R541.75
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