非冠心病患者白细胞端粒长度与阵发性心房颤动的相关性研究

摘要

目的 探讨非冠心病患者白细胞端粒长度与阵发性心房颤动(房颤)的相关性.方法 选择2014年5月～2016年1月在天津医科大学第二医院心脏科行冠状动脉造影术检查住院治疗的患者138例,根据诊断分为非房颤组88例和阵发性房颤组50例.抽取外周血并提取DNA,通过实时聚合酶链反应测量白细胞端粒长度,标化为端粒/单基因比值,记录并比较患者基线资料,采用非条件logistic回归分析二者相关性.结果 与非房颤组比较,阵发性房颤组心力衰竭、体质量指数、D-二聚体、纤维蛋白原明显升高,他汀类药物使用比例明显降低,差异有统计学意义(P＜0.05,P＜0.010).阵发性房颤组白细胞端粒较非房颤组更长,但差异无统计学意义[0.28(0.11,0.71)vs 0.20(0.06,0.46),P=0.100].logistic回归分析显示,白细胞端粒长度与阵发性房颤无相关性(OR=1.498,95％CI:0.924～2.426,P=0.100),调整年龄、体质量指数、D-二聚体及纤维蛋白原等混杂变量后,白细胞端粒长度与阵发性房颤无相关性(OR=0.960,95％CI:0.124～7.404,P=0.970).结论 非冠心病患者白细胞端粒长度与阵发性房颤发病无相关性.%Objective To study the association between leukocyte telomere length (LTL) and paroxysmal atrial fibrillation (PAF) in elderly non-CHD patients.Methods One hundred and thirtyeight patients who underwent coronary arteriography in our hospital from May 2014 to January 2016 were divided into AF-free group (n=88) and PAF group (n=50).Peripheral blood sample was taken to assay their DNA.Their LTL was measured by RT-PCR and presented as telomere/single gene ratio,their baseline data were recorded.Association between LTL and PAF was analyzed by non-conditional logistic regression analysis.Results The incidence of heart failure,BMI,serum D-dimer and fibrinogen levels were significantly higher in PAF group than in AF-free group (P＜0.05,P＜0.01).The LTL was longer in PAF group than in AF-free group but no significant difference was found between the.two groups [0.28 (0.11,0.71) vs 0.20 (0.06,0.46),P=0.100].Logistic regression analysis showed that LTL was not associated with PAF (OR=1.498,95％CI:0.924-2.426,P=0.100) and even after adjustment for age,BMI,serum D-dimer and fibrinogen level (OR=0.960,95％CI:0.124-7.404,P=0.970).Conclusion LTL is not associated with PAF in non-CHD patients.