持续性心房颤动患者左心房结构和炎性因子变化分析

目的 研究持续性心房颤动患者炎性因子与心房结构重构的关联性.方法 研究对象为45例持续性心房颤动组和45例对照组.研究对象行超声心动图检测左心房直径,行超声背向散射测定技术检测房间隔和左心房后壁背向散射积分值（integrated backscatter,IBS）和背向散射积分周期变化值（cyclic variation of integrated backscatter,CVIB）.行免疫比浊法和酶联免疫吸附法检测患者血清高敏C-反应蛋白（high-sensitivity C-reactionprotein,hs-CRP）,白细胞介素（interleukin,IL）-6和肿瘤坏死因子（tumor necrosis factor,TNF-α）浓度.结果 持续性心房颤动组左心房直径和血清Hs-CRP、IL-6、TNF-α浓度均高于对照组,差异有统计学意义（P＜0.05）.心房颤动患者左心房直径与各血清炎性因子浓度（hs-CRP、IL-6和TNF-α）呈正相关（r=0.825,P＜0.01;r=0.432,P＜0.01;r=0.357,P＜0.01）.左心房直径＞40 mm亚组血清hs-CRP、IL-6和TNF-α浓度均高于左心房直径≤40 mm亚组,差异有统计学意义（P＜0.05）.结论 炎性因素参与了心房颤动的发病过程,血清hs-CRP、IL-6和TNF-α浓度与心房颤动的持续状态有关,心房纤维化和心肌重构也参与了心房颤动的发生和维持.

Changes of left atrial structure and subclinical inflammatory factor in patients with persistent atrial fibrillation

Objectives To study the relationship between subclinical inflammatory factor and atrial structural remodeling in patients with persistent atrial fibrillation （AF）.Methods There were 45 patients in persistent AF group and 45 cases in control group.Left atrial diameter （LAD） was detected with Doppler ultrasonic diagnostic apparatus.Integrated backscatter （IBS） and （CVIB） were detected in atrial septal and posterior wall of the left atrium with quantitative analysis of ultrasonic backscatter.Serum concentrations of high-sensitivity C-reactive protein （hs-CRP）,interleukin-6 （IL-6） and tumor necrosis factor-α （TNF-α） were examined by turbidimetry and enzyme-linked immunosorbent assay （ELISA）detection.Results LAD,serum concentrations of hs-CRP,IL-6 and TNF-o in persistent AF group were significantly higher than those in control group （P〈0.05）.There was a positive correlation between LAD and serum concentrations of inflammatory factors （hs-CRP,IL-6 and TNF-α） in patients with persistent AF （r=0.825,P〈0.01 ; r=0.432,P〈0.01 ;r=0.357,P〈0.01）.Compared with LAD ≤40 mm AF subgroup,serum concentrations of hs-CRP,IL-6 and TNF-αsignificantly increased in LAD 〉40 mm AF subgroup （P〈0.05）.Conclusions Inflammatory factors are involved in the pathogenesis of AF.There is a correlation between serum concentrations of inflammatory factors （hs-CRP,IL-6 and TNF-α）and persistent AF.Atrial fibrosis and myocardial remodeling also participate in the occurrence and maintenance of AF.