摘要
目的分析血清骨桥蛋白(OPN)、松弛素(Relaxin)、半乳糖凝集素3(Gal-3)水平与心房颤动(AF)患者冷冻消融术后复发的关系。方法选择2018年1月—2020年3月于河北医科大学第二医院心血管内二科住院拟行冷冻消融手术的AF患者189例,根据术后3个月AF复发情况将患者分为复发组(47例)和无复发组(142例)。收集临床资料,检测手术前、术后3个月血清OPN、Relaxin、Gal-3水平,采用Logistic逐步回归分析影响冷冻消融术后患者AF复发的危险因素;以受试者工作特征曲线(ROC)分析术前OPN、Relaxin、Gal-3水平预测冷冻消融术后患者AF复发的价值。结果与术前比较,2组患者术后血清OPN、Relaxin、Gal-3水平均下降(复发组:t=28.239、5.451、34.915;无复发组:t=31.741、6.272、37.249,P均=0.000),且术前、术后复发组均高于无复发组(术前:t=8.239、2.546、6.078;术后:t=2.656、3.655、4.217,P均<0.05)。单因素分析结果显示,AF病程、AF类型、合并糖尿病、左心房内径(LAD)、LVEF、WBC与AF患者冷冻消融术后复发有关(t/χ^(2)/P=8.473/0.004、3.566/0.001、9.191/0.002、3.963/0.000、2.430/0.016、5.903/0.000),Logistic逐步回归分析结果显示,高LAD及高血清OPN、Relaxin、Gal-3水平是AF患者冷冻消融术后复发的危险因素[OR=1.640(95%CI 1.423~1.968)、1.978(95%CI 1.651~2.592)、2.472(95%CI 1.905~3.926)、2.273(95%CI 1.824~3.037)]。ROC分析结果显示,术前血清OPN、Relaxin、Gal-3及3者联合预测AF患者冷冻消融术后复发的曲线下面积(AUC)分别为0.804、0.661、0.873、0.928,敏感度分别为72.34%、65.96%、76.60%、93.62%,特异度分别为78.87%、77.46%、90.14%、92.96%,约登指数分别为0.51、0.43、0.67、0.87。结论AF冷冻消融术后复发患者血清OPN、Relaxin、Gal-3水平显著升高,术前高血清OPN、Relaxin、Gal-3水平与AF患者冷冻消融术后复发密切相关,可为AF患者术后短期预后评估提供参考。
Objective To analyze the relationship between serum osteopontin(OPN),relaxin(Relaxin),galectin 3(Gal-3)levels and recurrence after cryoablation in patients with atrial fibrillation(AF).Methods From January 2018 to March 2020,189 patients with AF who were hospitalized in the Second Department of Cardiovascular Medicine of the Second Hospital of Hebei Medical University and planned to undergo cryoablation surgery were selected,and the patients were divided into recurrence groups according to AF recurrence 3 months after surgery(47 Cases)and the recurrence-free group(142 cases).Collect clinical data,detect serum OPN,Relaxin,and Gal-3 levels before and 3 months after surgery,and use Logistic stepwise regression to analyze risk factors affecting AF recurrence in patients after cryoablation;use receiver operating characteristic curve(ROC)to analyze Preoperative OPN,Relaxin and Gal-3 levels predict the value of AF recurrence in patients after cryoablation.Results Compared with preoperatively,the serum OPN,Relaxin,and Gal-3 levels of the two groups decreased after operation(t=28.239,5.451,34.915,31.741,6.272,37.249,P=0.000),and both preoperative and postoperative recurrence groups Higher than the recurrence-free group(t=8.239,2.546,6.078,2.656,3.655,4.217,all P<0.05).Univariate analysis showed that the course of AF,type of AF,diabetes,left atrial diameter(LAD),LVEF,WBC were related to recurrence after cryoablation in AF patients(t/χ^(2)/P=8.473/0.004,3.566/0.001,9.191/0.002,3.963/0.000,2.430/0.016,5.903/0.000),Logistic stepwise regression analysis results showed that high LAD and high serum OPN,Relaxin,Gal-3 levels are risk factors for recurrence after cryoablation in AF patients[OR=1.640(95%CI 1.423~1.968),1.978(95%CI 1.651~2.592),2.472(95%CI 1.905~3.926),2.273(95%CI 1.824~3.037)].ROC analysis results showed that the area under the curve(AUC)of preoperative serum OPN,Relaxin,Gal-3 and 3 combined to predict the recurrence of AF patients after cryoablation were 0.804,0.661,0.873,0.928,and the sensitivity was 72.34%,respectively.65.96%,76.60%,93.62%,the specificity was 78.87%,77.46%,90.14%,92.96%,and the Youden index were 0.51,0.43,0.67,0.87.Conclusion Serum OPN,Relaxin,and Gal-3 levels in patients with recurrence after AF cryoablation increased significantly.The preoperative high serum OPN,Relaxin,Gal-3 levels are closely related to the recurrence of AF patients after cryoablation,which can provide a reference for the short-term prognosis evaluation of AF patients.
作者
靳雅琼
鲁静朝
刘凡
王梦肖
张洁
Jin Yaqiong;Lu Jingchao;Liu Fan;Wang Mengxiao;Zhang Jie(Department of Cardiology, The Second Hospital of Hebei Medical University, Hebei Province, Shijiazhuang 050000,China)
出处
《疑难病杂志》
CAS
2021年第1期26-30,36,共6页
Chinese Journal of Difficult and Complicated Cases
基金
河北省医学科学研究课题计划(20190568)。
