目的 通过临床资料研究心房颤动(atrial fibrillation,AF)与β2微球蛋白(beta 2-microglobulin,β2-MG)之间的相关性,以期为临床AF诊治提供参考价值.方法 根据纳入排除标准收集在天津市某三甲医院2022年9月至2023年12月期间在心内科住院的患者142例,分为除外冠心病的AF组70例和造影正常的对照组72例,比较两组间的血、尿β2-MG、程序性细胞死亡因子 4(programmed cell death factor 4,PDCD4)、转化生长因子(transforming growth factor-β1,TGF-β1)及心脏超声等各指标.结果 AF组与对照组在年龄、性别、民族、吸烟史、饮酒史、高血压病史、糖尿病史、高脂血症病史、家族遗传史、肥胖等方面差异无统计学意义(P＞0.05);在利伐沙班、达比加群酯、华法林等抗凝药物以及胺碘酮的使用方面更多(P＜0.05);在β受体阻滞剂(β-blocker)、离子拮抗剂(CCB)、血管紧张素转换酶抑制剂/血管紧张素受体拮抗剂(ACEI/ARB)、阿司匹林、他汀类药物及索他洛尔的使用方面差异无统计学意义(P＞0.05);在血糖指标方面差异无统计学意义(P＞0.05);在总胆固醇(total cholesterol,TC)、甘油三醋(triglyceride,TG)、高密度脂蛋白胆固醇(high density liptein cholesterol,HDLc)、低密度脂蛋白胆固醇(low density liptein cholesterol,LDLc)、极低密度脂蛋白胆固醇(very low density liptein cholesterol,VLDLc)、动脉粥样硬化指数(low density liptein/high density liptein,LDL/HDL)等血脂指标方面差异无统计学意义(P＞0.05),而LDLc指标差异有统计学意义(P＜0.05);在室间隔厚度、左室舒张末内径、左室收缩末内径、左室后壁厚度、右室前壁厚度、右室舒张末内径、主动脉瓣环内径、主动脉瓣开内径、肺动脉内径、射血分数、二尖瓣血流等心脏超声指标方面差异无统计学意义(P＞0.05),而左房内径指标差异有统计学意义(P＜0.05);在血β2-MG、尿β2-MG、TGF-β1、PDCD4等临床指标方面AF组均高于对照组,差异有统计学意义(P＜0.05).以是否为AF为因变量,以是否有利伐沙班、达比加群酯、华法林等抗凝药物以及胺碘酮等用药史,LDLc、左房内径、TGF-β1、PDCD4、血β2-MG、尿β2-MG等临床指标为自变量,进行logistic回归分析,结果显示AF发生与左房内径、PDCD4、TGF-β,、血β2-MG、尿β2-MG指标有关(P＜0.05).结论 通过临床资料前瞻性研究推测AF与β2-MG之间存在一定的关系,β2-MG与AF的发生发展过程中可能有TGF-β1、PDCD4参与.
Correlation between atrial fibrillation and beta2 microglobulin
Objective To understand the correlation between atrial fibrillation(AF)and β2 microglobulin(beta2-microglobulin,β2-MG)through three parts of clinical data research,and to provide the reference value in diagnosis and treatment.Methods According to the inclusion and exclusion criteria,142 patients who were hospitalized in the cardiology department of a hospital in Tianjin from September 2022 to December 2023 were collected and divided into 70 cases of AF except for coronary heart disease and 72 cases of control group with normal angiography.Blood,urine β2-MG,PDCD4,TGF-β1 and cardiac ultrasound were compared between the two groups.Results Compared with the control group,in AF group no significant differences were seen in age,gender,ethnicity,smoking history,drinking history,hypertension history,diabetes history,hyperlipidemia history,family genetic history and obesity,etc.(P＞0.05),and more anticoagulants were used such as rivaroxaban,dabigatran etexilate,warfarin and amiodarone(P＜0.05),and no significant differences were seen in use of beta-blockers(β-blockers),ion antagonists(CCB),tubulotensin converting enzyme inhibitors/tubulotensin receptor antagonists(ACEI/ARB),aspirin,statins and sotalol(P＞0.05).There was no statistically significant difference in blood glucose(GLU)indexes(P＞0.05).No significant differences were seen between the two groups in total cholesterol(TC),triglyceride(TG),high density liptein cholesterol(HDLc),low density liptein cholesterol(LDLc),very low density liptein cholesterol(VLDLc),atherosclerosis index(low density liptein/high density liptein,LDL/HDL)and other blood lipid indexes(P＞0.05),but there was a significant difference in LDLc indexes(P＜0.05).There was no significant differences in ventricular septal thickness,left ventricular end-diastolic diameter,left ventricular end-systolic diameter,left ventricular posterior wall thickness,right ventricular anterior wall thickness,right ventricular end-diastolic diameter,aortic annulus diameter,aortic valve opening diameter,pulmonary artery diameter,ejection fraction,mitral valve blood flow and other cardiac ultrasound indexes were compared(P＞0.05),and the difference in left atrial diameter was statistically significant(P＜0.05).The differences in blood β2-MG,urine β2-MG,TGF-β1,PDCD4 and other clinical indexes were significant(P＜0.05).Logistic regression analysis showed that the occurrence of atrial fibrillation was related to left atrial diameter,PDCD4,TGF-β1,blood β2-MG and urine β2-MG indexes(P＜0.05).Conclusion Based on the prospective study of clinical data research,it is inferred that there is a certain relationship between atrial fibrillation and β2-microglobulin,and β2-MG is involved in the occurrence and development of atrial fibrillation.It is possible that TGF-β1 and PDCD4 are involved.
Atrial fibrillationBeta2-microglobulinProgrammed cell death factor 4Transforming growth factor-β1
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