脂蛋白相关性磷脂酶A2及高敏C反应蛋白与左心房内径的关系

目的:观察不同类型心房颤动（房颤）患者左心房内径（LAD）与脂蛋白相关性磷脂酶A2（Lp-PLA2）及高敏C-反应蛋白（hs-CRP）水平之间的关系，探讨炎症诱发房颤的机制。方法:将122例房颤患者分为阵发性房颤组38例，持续性房颤组40例，永久性房颤组44例，随机选取41例窦性心律患者为对照组，记录患者临床资料及检测指标。结果:Lp-PLA2水平在持续性房颤组及永久性房颤组明显高于阵发性房颤组及对照组（P＜0.05）。hs-CRP水平在持续性房颤组及永久性房颤组高于阵发性房颤及对照组，阵发房颤组高于对照组（P＜0.05）。LAD在永久性房颤组及持续性房颤组大于阵发性房颤组和持续性房颤组（P＜0.05）。阵发房颤组中hs-CRP与LAD成正相关，持续性房颤组及永久性房颤组中Lp-PLA2、hs-CRP与LAD均呈正相关。结论:炎症在房颤的发生、发展和维持中发挥着重要作用，作用机制之一可能与炎症导致心房重构有关。

Relationship between plasma lipoprotein-associated phospholipase A2,high sensitivity C reactive protein and left atrial diameter

Objective:To observe the relationship between plasma levels of lipoprotein-associated phospholipase A2(Lp-PLA2) ， high sensitivity C reactive protein (hs-CRP) and Left atrial diameter (LAD) in patients with different types of atrial fibrillation(AF) and to explore the mechanism of inflammation-induced atrial fibrillation. Methods:One hundred and twenty two atrial fibrillation patients were divided into three groups:paroxysmal atrial fibrillation group (A, n=38), persistent atrial fibrillation group (B, n=40) and permanent atrial fibrillation group (C, n=44).Furthermore, forty-one sinus rhythm patients was randomly selected as control group (D， n=41). Basic clinical data and testing indexes of all groups were recorded. Results:Lp-PLA2 level in persistent and permanent group were significantly higher that in than paroxysmal and control groups(P<0.05).Hs-CRP levels in persistent and permanent groups were higher than those in paroxysmal and control groups. Paroxysmal group was also higher than control group (P<0.05).LAD in permanent and persistent groups were greater than paroxysmal and control group(P<0.05).Hs-CRP was positively correlated with LAD in paroxysmal group. Hs-CRP and Lp-PLA2 were positively correlated with LAD both in persistent and permanent groups. Conclusion: Inflammation is an important factor for genesis, developing and sustaining atrial fibrillation .One mechanism may be related to inflammation induced atrial remolding.