房颤患者C反应蛋白和氧化应激因子的检测及意义

目的 检测高敏C反应蛋白（hs-CRP）、硫氧还蛋白（TRX）、超氧化物歧化酶（SOD）在房颤发生、发展中量的变化以探讨房颤的发病机制.方法 随机选取持续性房颤患者（持续性房颤组）41例、阵发性房颤患者（阵发性房颤组）42例,对照组39例,用ELISA法检测患者血清中hs-CRP、TRX、SOD表达水平,同时应用超声心动图测定各组左心房内径（LAD）,并对各指标作相关性分析.结果 （1）血清hs-CRP、TRX水平及LAD值持续性房颤组、阵发性房颤组均高于对照组,持续性房颤组高于阵发性房颤组,差异有统计学意义（均P＜0.01）;（2）持续性房颤组、阵发性房颤组SOD活性均低于对照组,持续性房颤组低于阵发性房颤组,差异有统计学意义（均P＜0.01）;（3）LAD与hs-CRP呈正相关（r=0.817,P＜0.01）,与SOD呈负相关（r=-0.825,P＜0.01）,与TRX呈正相关（r=0.919,P＜0.01）.结论 炎症和氧化应激可能参与了左心房的电重构及结构重构,并促进了房颤的发生、发展.

Detection of serum hs-CRP and oxidative stress factors in patients with atrial fibrillation and its clinical significance

Objective To evaluate the clinical applicability of high sensitivity-C reactive protein （hs-CRP）, thioredoxin （TRX）, superoxide dismutase（ SOD ）in patients with atrial fibrillation（AF）. Methods Forty one patients with persistent AF admitted to the Hangzhou Third People＇s Hospital were enrolled; and 42 patients with paroxysmal AF and 39 healthy subjects （controls） were also included in the study. The serum levels of hs-CRP, TRX and SOD were detected with enzyme-linked immunosorbent assay （ELISA）, and the left atrium diameter （LAD） was measured by echocardiogram. And the correlation among parameters was analyzed. Results The serum levels of hs-CRP, TRX and LAD in patients with persistent AF and paroxysmal AF were significantly higher than those in the control group （P〈0.01）. And the levels of above parameters in persistent AF group were significantly higher than those in paroxysmal AF group （P〈0.01）. The serum SOD levels in patients with persistent AF and paroxysmal AF were significantly lower than those in the control group （P〈0.01）, while SOD levels of persistent AF were significantly lower than paroxysmal AF （P〈0.01）. LAD was positively correlated with hs-CRP （r=0.817, P〈0.01） and TRX （r=0.919,P〈0.01）, and negatively correlated with SOD （r=-0.825,P〈0.01）. Conclusion The inflammation and oxidative stress might be involved in the structural or electrical remodeling of the left atrium, resulting in the development of AF.