| 程俊华,王淑贤,陈荣梅,李志强,王建红,张永红.血清Apelin、CD40L、Gal-3与慢性心力衰竭患者心脏再同步化治疗后室性心律失常的关系及其预测价值研究[J].,2024,(17):3326-3331 |
| 血清Apelin、CD40L、Gal-3与慢性心力衰竭患者心脏再同步化治疗后室性心律失常的关系及其预测价值研究 |
| Study of the Relationship between Serum Apelin, CD40L, Gal-3 and Ventricular Arrhythmia after Cardiac Resynchronization Therapy in Patients with Chronic Heart Failure and its Predictive Value |
| 投稿时间：2024-03-08 修订日期：2024-03-31 |
| DOI：10.13241/j.cnki.pmb.2024.17.025 |
| 中文关键词: 慢性心力衰竭 心脏再同步化治疗 Apelin CD40L Gal-3 室性心律失常 |
| 英文关键词: Chronic heart failure Cardiac resynchronization therapy Apelin CD40L Gal-3 Ventricular arrhythmia |
| 基金项目:山西省卫生计生委科研基金项目（2017142） |
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| 中文摘要: |
| 摘要 目的：探讨血清爱帕琳肽（Apelin）、分化簇40配体（CD40L）、半乳糖凝集素-3（Gal-3）与慢性心力衰竭（CHF）患者心脏再同步化治疗（CRT）后室性心律失常的关系及其预测价值。方法：选取2018年1月～2022年10月在山西医科大学附属太钢总医院、山西医科大学附属心血管病医院接受CRT的CHF患者共235例纳入CHF组，另选取同期上述两院共150名体检健康者作为对照组。检测并对比所有受试者的血清Apelin、CD40L、Gal-3水平。CHF患者CRT后随访1年，根据是否发生室性心律失常分为室性心律失常组（48例）和非室性心律失常组（187例）。多因素Logistic回归分析CHF患者CRT后室性心律失常发生的影响因素。受试者工作特征（ROC）曲线分析血清Apelin、CD40L、Gal-3预测CHF患者CRT后室性心律失常发生的价值。结果：与对照组比较，CHF组血清Apelin水平降低，CD40L、Gal-3水平升高（P＜0.05）。随访1年，235例CHF患者CRT后室性心律失常发生率为20.43%。Apelin升高为CHF患者CRT后室性心律失常发生的保护因素，纽约心脏病协会（NYHA）心功能分级Ⅳ级和CD40L、Gal-3升高为危险因素（P＜0.05）。联合血清Apelin、CD40L、Gal-3预测CHF患者CRT后室性心律失常发生的曲线下面积（AUC）为0.911，大于血清Apelin、CD40L、Gal-3单独预测的0.770、0.754、0.760。结论：CHF患者的血清Apelin水平降低、CD40L、Gal-3水平升高与CRT后室性心律失常的发生有关，血清Apelin、CD40L、Gal-3水平联合检测对CHF患者CRT后室性心律失常的发生具有较高的预测价值。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the relationship between serum apelin (Apelin), cluster of differentiation 40 ligand (CD40L), galectin-3 (Gal-3) and ventricular arrhythmia after cardiac resynchronization therapy (CRT) in patients with chronic heart failure (CHF) and its predictive value. Methods: 235 CHF patients who underwent CRT at Taigang General Hospital Affiliated to Shanxi Medical University and Cardiovascular Hospital Affiliated to Shanxi Medical University from January 2018 to October 2022 were selected as the CHF group. In addition, 150 healthy individuals who underwent physical examinations at the two hospitals during the same period were selected as the control group. The serum Apelin, CD40L and Gal-3 levels of all subjects were detected and compared. CHF patients were followed up for 1 year after CRT, and patients were divided into ventricular arrhythmia group (48 cases) and non-ventricular arrhythmia group (187 cases) according to whether ventricular arrhythmia occurred. The influencing factors of ventricular arrhythmia after CRT in CHF patients were analyzed by multivariate Logistic regression. The value of serum Apelin, CD40L and Gal-3 in predicting the occurrence of ventricular arrhythmias after CRT in CHF patients were analyzed by receiver operating characteristic (ROC) curve. Results: Compared with control group, the serum Apelin level in CHF group was decreased, and the levels of CD40L and Gal-3 were increased (P<0.05). After 1 year of follow-up, the incidence of ventricular arrhythmia after CRT in 235 CHF patients was 20.43%. Increased Apelin was protective factors for ventricular arrhythmias after CRT in CHF patients, and the New York Heart Association (NYHA) cardiac function classification IV and CD40L, Gal-3 increased were risk factors (P<0.05). The area under the curve (AUC) of combined serum Apelin, CD40L and Gal-3 in predicting the occurrence of ventricular arrhythmia after CRT in CHF patients was 0.911, which was greater than 0.770, 0.754 and 0.760 predicted by serum Apelin, CD40L and Gal-3 alone. Conclusion: The decrease of serum Apelin level and the increase of CD40L and Gal-3 levels in CHF patients are relate to the occurrence of ventricular arrhythmia after CRT, the combine detection of serum Apelin, CD40L and Gal-3 levels has a high predictive value for the occurrence of ventricular arrhythmia after CRT in CHF patients. |
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