血清成纤维细胞生长因子23与心房颤动的关系

摘要

目的 探讨血清成纤维细胞生长因子23(FGF23)在房颤患者中的作用及意义.方法 选择2017年6月至2018年6月于武汉大学人民医院心内科住院患者300例,根据是否为房颤患者及房颤持续时间分为窦性心律组、阵发性房颤组、持续性房颤组,每组各100例,ELISA法检测血清FGF23浓度,比较三组患者的临床资料及血液学指标,采用多元Logsitic回归分析房颤患者发生和维持的危险因素.结果 阵发性房颤组、持续性房颤组的FGF23、N末端脑钠肽前体(NT-proBNP)水平及左房直径明显高于窦性心律组(206.25±59.21 ng/ml vs. 238.16±60.40 ng/ml vs. 122.63±41.10 ng/ml,P＜0.05),(519.58± 93.47 pg/ml vs. 568.05±103.64 pg/ml vs. 409.17±79.54 pg/ml,P＜0.05),(39.59±4.18 mm vs. 41.24±4.49 mm vs. 36.97±3.53 mm,P＜0.05),且持续性房颤组的FGF23、NT-proBNP水平及左房直径明显高于阵发性房颤组(238.16±60.40 ng/ml vs. 206.25±59.21 ng/ml,P＜0.05),(568.05±103.64 pg/ml vs. 519.58± 93.47 pg/ml,P＜0.05),(41.24±4.49mm vs. 39.59±4.18 mm,P＜0.05).多元Logistic回归分析结果显示FGF23、NT-proBNP、左房直径是患者房颤发生及发展的危险因素(P＜0.05).结论 房颤患者血清FGF23水平上调且明显高于窦性心律组,FGF23可能对房颤的发生和维持起重要作用.%Objective To discuss the role and significance of serum fibroblast growth factor 23 (FGF23) in patients with atrial fibrillation (AF). Methods The patients (n=300) were chosen from Department of Cardiology of Renmin Hospital of Wuhan University from June 2017 to June 2018. All patients were divided, according to whether or not with AF and AF duration, into sinus rhythm group, paroxysmal AF group and persistent AF group (each n=100). The concentration of serum FGF23 was detected by using ELISA, and clinical data and hematological indexes were compared among 3 groups. The risk factors of AF occurrence and maintenance were analyzed by using multi-factor Logsitic regression analysis. Results The levels of FGF23 and NT-proBNP and left atrial diameter (LAD) were significantly higher in paroxysmal AF group and persistent AF group than those in sinus rhythm group (206.25±59.21 ng/ml vs. 238.16±60.40 ng/ml vs. 122.63±41.10 ng/ml, P<0.05), (519.58±93.47 pg/ml vs. 568.05±103.64 pg/ml vs. 409.17±79.54 pg/ml, P<0.05) and (39.59±4.18 mm vs. 41.24±4.49 mm vs. 36.97± 3.53 mm, P<0.05). The levels of FGF23 and NT-proBNP and LAD were significantly higher in persistent AF group than those in paroxysmal AF group (238.16±60.40 ng/ml vs. 206.25±59.21 ng/ml, P<0.05), (568.05±103.64 pg/ml vs. 519.58±93.47 pg/ml, P<0.05) and (41.24±4.49 mm vs. 39.59±4.18 mm, P<0.05). The results of Logsitic regression analysis showed that FGF23, NT-proBNP and LAD were risk factors of AF occurrence and development (P<0.05). Conclusion The level of FGF23 is up-regulated and significantly higher in AF patients than that in those with sinus rhythm, and FGF23 may be important to AF occurrence and maintenance.