[1]董丹丹,姜玉连.老年非瓣膜性心房颤动患者血清Periostin，UAR水平表达与射频消融术后复发的相关性研究[J].现代检验医学杂志,2025,40(01):138-142.[doi:10.3969/j.issn.1671-7414.2025.01.026]
　DONG Dandan,JIANG Yulian.Correlation between Expression of Serum Periostin and UAR Levels in Elderly Patients with Nonvalvular Atrial Fibrillation and Recurrence after Radiofrequency Ablation[J].Journal of Modern Laboratory Medicine,2025,40(01):138-142.[doi:10.3969/j.issn.1671-7414.2025.01.026]
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老年非瓣膜性心房颤动患者血清Periostin，UAR水平表达与射频消融术后复发的相关性研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第40卷
期数:
2025年01期
页码:
138-142
栏目:
论著
出版日期:
2025-01-15

文章信息/Info

Title:
Correlation between Expression of Serum Periostin and UAR Levels in Elderly Patients with Nonvalvular Atrial Fibrillation and Recurrence after Radiofrequency Ablation
文章编号:
1671-7414（2025）01-138-05
作者:
董丹丹; 姜玉连
（首都医科大学附属北京同仁医院心血管中心，北京 100176）
Author(s):
DONG Dandan; JIANG Yulian
（Cardiovascular Center, Beijing Tongren Hospital Affiliated to Capital Medical University, Beijing 100176, China）
关键词:
非瓣膜性心房颤动; 骨膜蛋白; 尿酸/ 清蛋白比率; 射频消融术
分类号:
R541.75；R446.11
DOI:
10.3969/j.issn.1671-7414.2025.01.026
文献标志码:
A
摘要:
目的 探究老年非瓣膜性心房颤动（NVAF）患者血清骨膜蛋白（Periostin）、尿酸/ 清蛋白比率（UAR）水平与射频消融术（RFCA）后复发的相关性。方法 选取2019 年1 月～ 2022 年10 月在首都医科大学附属北京同仁医院心血管中心接受RFCA 治疗的108 例老年NAVF 患者为观察组，选取同期在首都医科大学附属北京同仁医院体检的108 例健康者作为对照组，对患者进行为期一年的随访，根据随访情况将其分为复发组（n=42）和未复发组（n=66）。收集患者性别、年龄、体质量指数（BMI）、高血压史、糖尿病史、高血脂史、吸烟史、饮酒史、左心室射血分数（LVEF）、左心室舒张末期直径（LVEDD）和白细胞计数（WBC）；采用酶联免疫吸附测定法（ELISA）检测血清Periostin 含量；采用全自动生化分析仪测定血清清蛋白（ALB）和尿酸（UA）含量，其比值即为UAR 水平。采用Logistic 回归分析NVAF 患者RFCA 后复发的影响因素；受试者工作特征（ROC）曲线分析血清Periostin，UAR 水平对老年NAVF患者RFCA 后复发的预测价值。结果 观察组术前Periostin（53.53±6.27 ng/L），UAR（4.09±0.78）水平显著高于术后（50.53±7.23 ng/L，3.41±0.91）和对照组（31.29±4.21 ng/L，1.24±0.27），差异具有统计学意义（t=3.258，30.603；5.896，35.883， 均P<0.05）。复发组LVEF（51.16%±6.49%） 低于未复发组（55.39% ± 6.71%），UAR（4.01±0.92）、Periostin（55.77±6.56 ng/L）和高血脂史占比（66.67% ）水平高于未复发组（3.02±0.63，47.19±5.44ng/L，34.85%）， 差异具有统计学意义（χ2/t=3.234，6.458，7.180，10.426， 均P<0.05）。血清Periostin[OR(95%CI)：1.856(1.148 ～ 3.000）]，UAR[OR(95% CI)：2.127(1.145 ～ 3.951）] 为患者RFCA 后复发的独立危险因素（均P<0.05）；血清Periostin，UAR 水平预测老年NAVF 患者RFCA 后复发的曲线下面积（95% 置信区间）[AUC(95%CI)]分别为0.856(0.776 ～ 0.916)，0.817（0.731 ～ 0.884），截断值分别为53.00ng/L，3.99，约登指数分别为0.569，0.509，敏感度分别为88.10%，85.71%，特异度分别为71.21%，65.15%；二者联合预测的AUC(95%CI)，约登指数、敏感度、特异度分别为0.924（0.857 ～ 0.966），0.736，85.71% 和87.88%，二者联合预测高于各指标单独预测（Z =2.296，2.880；P=0.022，0.004）。结论 老年NAVF 患者血清Periostin，UAR 水平上调，与RFCA 后复发存在一定的关联，二者联合预测老年NAVF 患者RFCA 后复发具有较高效能。
Abstract:
Objective To exploring the correlation between serum periostin, uric acid/albumen ratio(UAR) levels and recurrence after radiofrequency ablation (RFCA) in elderly patients with nonvalvular atrial fibrillation (NVAF). Methods The 108 elderly NAVF patients who received RFCA treatment at the Cardiovascular Center of Peking Tongren Hospital Affiliated to Capital Medical University from January 2019 to October 2022 were selected as the observation group, selected 108 healthy individuals who had medical checkups at Beijing Tongren Hospital Affiliated to Capital Medical University during the same period as the control group, and the patients were followed up for a period of 1 year. And according to the follow-up, they were divided into the recurrence group (n=42) and the non-recurrence group (n=66). Sex，age，body mass index (BMI), history of hypertension, diabetes mellitus, hyperlipidemia, smoking, alcohol consumption, left ventricular ejection fraction (LVEF), left ventricular enddiastolic diameter (LVEDD), white blood cell counts were collected. Enzyme linked immunosorbent assay (ELISA) was applied to detect serum Periostin level. Fully automated biochemical analyzer was applied to measure the levels of serum albumin (ALB) and uric acid (UA), whose ratio was the level of UAR. Logistic regression was applied to analyze the influencing factors of recurrence in NVAF patients after RFCA. Receiver Operating Characteristic (ROC) curve was applied to analyze the predictive value of serum Periostin and UAR levels for recurrence after RFCA in elderly NAVF patients. Results Preoperative Periostin, UAR levels in the observation group were significantly higher than serum Periostin (53.53±6.27ng/L), UAR (4.09±0.78) in the postoperative（50.53±7.23 ng/L，3.41±0.91）and control groups（31.29±4.21 ng/L，1.24±0.27）, and the differences were statistically significant (t=3.258, 30.603; 5.896, 35.883，all P<0.05). The LVEF was lower in the recurrent group (51.16%±6.49%) than in the non-recurrent group (55.39%±6.71 %)，the levels of UAR (4.01±0.92), Periostin (55.77±6.56 ng/L) and percentage of history of hyperlipidemia (66.67%) were higher in the relapse group than those in the non-relapse group （3.02±0.63，47.19±5.44 ng/L，34.85%）, and the differences were statistically significant (χ2/t=3.234, 6.458, 7.180， 10.426，all P<0.05). Serum Periostin[OR(95% CI)：1.856(1.148 ～ 3.000）] and UAR[OR(95% CI)：2.127(1.145 ～ 3.951）] were independent risk factors for recurrence after RFCA in patients (P<0.05). The area under the curve (95% confidence interval) [AUC(95%CI)]of serum Periostin and UAR levels to predict relapse after RFCA in elderly NAVF patients were 0.856(0.776 ～ 0.916)，0.817（0.731 ～ 0.884）, respectively, the cutoff values were 53.00 ng/L, 3.99，the Youden index was 0.569, 0.509, the sensitivity was 88.10%, 85.71% and the specificity was 71.21%, 65.15%,respectively. The combined predicted of the AUC(95%CI), Youdon index,sensitivity and specificity by the two method were as flows 0.924 (0.857 ～ 0.966), 0.736, 85.71% and 87.88%, respectively. The combined prediction was significantly higher than that of each index alone (Z=2.296，2.880， P=0.022, 0.004). Conclusion Serum Periostin and UAR levels are upregulated in elderly patients with NAVF, there is a certain correlation with recurrence after RFCA, the combination of the two has a high efficacy in predicting recurrence in elderly NAVF patients after RFCA.

参考文献/References:

[1] PATEL D, RAO A, FRIEDMAN P A, et al. New atrial arrhythmia occurrence in single chamber implantable cardioverter defibrillator patients: a realworld investigation[J]. Journal of Cardiovascular Electrophysiology, 2023, 34(2): 438-444.
[2] LIU H T, CHANG Pocheng, LEE H L, et al. Catheter ablation of atrial fibrillation via retrograde aortic approach in a patient with interrupted inferior vena cava: a case report[J]. Journal of Geriatric Cardiology, 2023, 20(12): 877-879.
[3] WANG Wei, GU Yufeng, WEI Shan, et al. Standardized community management on the diagnosis, treatment, and risk factors control for non-valvular atrial fibrillation in elderly patients[J]. BMC Primary Care, 2023, 24(1): 257.
[4] WANG Jianlong, ZHOU Kuo, QIN Zheng, et al. Minimally invasive thoracoscopic left atrial appendage occlusion compared with transcatheter left atrial appendage closure for stroke prevention in recurrent nonvalvular atrial fibrillation patients after radiofrequency ablation: a prospective cohort study[J]. Journal of Geriatric Cardiology, 2021, 18(11): 877-885.
[5] FANG Lijuan, JIN Hong, LI Min, et al. Serum Periostin as a predictor of early recurrence of atrial fibrillation after catheter ablation[J]. Heart and Vessels, 2022, 37(12): 2059-2066.
[6] SEL?UK M, ?INAR T, ?AYLIK F, et al. Predictive value of uric acid/albumin ratio for the prediction of new-onset atrial fibrillation in patients with ST-elevation myocardial infarction[J]. Revista Investigacion Clinica, 2022, 74(3): 156-164.
[7] AOYAMA D, UZUI H, SEKIHARA T, et al. Declines in serum uric acid level after catheter ablation of atrial fibrillation[J]. Heart and Vessels, 2022, 37(12): 2049-2058.
[8] ZHONG Xia, JIAO Huachen, ZHAO Dongsheng, et al. Association between serum albumin levels and paroxysmal atrial fibrillation by gender in a Chinese population: a case-control study[J]. BMC Cardiovascular Disorders, 2022, 22(1): 387.
[9] 《老年人心房颤动诊治中国专家建议》写作组, 中华医学会老年医学分会, 中华老年医学杂志编辑委员会. 老年人非瓣膜性心房颤动诊治中国专家建议(2016)[J]. 中华老年医学杂志, 2016, 35(9): 915-928. Writing Committee for Expert Consensus on the Management of Atrial Fibrillation in Elderly Population, Chinese Geriatric Society, Editorial Board of Chinese Journal of Geriatrics. Expert consensus on the management of atrial fibrillation in elderly population(2016)[J]. Chinese Journal of Geriatrics, 2016, 35(9): 915-928.
[10] CASINI S, MARCHAL G A, KAWASAKI M, et al. Differential sodium current remodelling identifies distinct cellular proarrhythmic mechanisms in paroxysmal vs persistent atrial fibrillation[J]. Canadian Journal of Cardiology, 2023, 39(3): 277-288.
[11] 彭琛, 沈相福, 卫静茹, 等. 不同剂量利伐沙班对高龄非瓣膜性心房颤动患者卒中预防效果及安全性评价[J]. 中国现代医学杂志, 2022, 32(13): 81-86. PENG Chen, SHEN Xiangfu, WEI Jingru, et al. Effect and safety evaluation of different doses of rivaroxaban on stroke prevention in elderly patients with nonvalvular atrial fibrillation [J]. China Journal of Modern Medicine, 2022, 32(13): 81-86.
[12] XIE Zhonglei, QI Baozhen, WANG Zimu, et al. Ablation for atrial fibrillation improves the outcomes in patients with heart failure with preserved ejection fraction[J]. Europace, 2023, 26(1): euad363.
[13] HORTELLS L, VALIENTE-ALANDI I, THOMAS Z M, et al. A specialized population of Periostinexpressing cardiac fibroblasts contributes to postnatal cardiomyocyte maturation and innervation[J]. Proceedings of the National Academy of Sciences of the U S A, 2020, 117(35): 21469-21479.
[14] DIXON I M C, LANDRY N M, RATTAN S G. Periostin reexpression in heart disease contributes to cardiac interstitial remodeling by supporting the cardiac myofibroblast phenotype [J]. Advances in Experimental Medicine and Biology, 2019, 1132: 35-41.
[15] 戎成振, 卢家忠, 杨静静, 等. Periostin 蛋白在心力衰竭合并心房颤动患者血清中的表达及其诊断预后价值[J]. 心脏杂志, 2022, 34(6): 654-658. RONG Chengzhen, LU Jiazhong, YANG Jingjing, et al. Expression of Periostin protein in serum of patients with heart failure complicated and atrial fibrillation and its diagnostic and prognostic value[J]. Chinese Heart Journal, 2022, 34(6): 654-658.
[16] YANG Jian, LOU Lian, ZHANG Xuan, et al. The relationship between uric acid and the development, complication, and prognosis of atrial fibrillation: the views from a clinical study [J]. International Journal of Endocrinology, 2022, 2022：9355504.
[17] ZHANG Qian, WEI Yangyan, HUANG Siyang, et al. The impact of serum uric acid on postoperative atrial fibrillation in coronary artery bypass graft[J]. Heart Surgery Forum, 2022, 25(2): E320-E325.
[18] 范彩霞, 李娇, 魏延津, 等. 心房颤动患者华法林抗凝治疗初期发生抗凝过度的影响因素研究[J]. 中国全科医学, 2024, 27(3): 308-314. FAN Caixia, LI Jiao, WEI Yanjin, et al. Influencing factors of overanticoagulation at initial stage of warfarin anticoagulation therapy in patients with atrial fibrillation[J]. Chinese General Practice, 2024, 27(3): 308-314.
[19] KAWAI M, HARADA M, MOTOIKE Y, et al. Impact of serum albumin levels on supratherapeutic PT-INR control and bleeding risk in atrial fibrillation patients on warfarin: a prospective cohort study [J]. International Journal of Cardiology Heart Vasculature, 2019, 22: 111-116.
[20] KARATA? M B, DURMU? G, ZENGIN A, et al. Association of uric acid albumin ratio with recurrence of atrial fibrillation after cryoballoon catheter ablation[J]. Medicina (Kaunas, Lithuania), 2022, 58(12): 1872.

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备注/Memo

备注/Memo:
作者简介：董丹丹（1982-），女，硕士，主治医师，研究方向：冠心病、心律失常、高血压，E-mail：dd98r1@163.com。
更新日期/Last Update: 2025-01-15