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血清CCN5与房颤患者左房低电压面积的相关性研究
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Abstract:
目的：探讨房颤患者血清CCN5水平是否可以预测左房低电压面积(LVZ)的大小。方法：选取2023年6月到2024年1月于烟台毓璜顶医院就诊的窦性心律患者(对照组) 79例以及首次接受心脏射频消融术的房颤患者(房颤组)114例。收集一般资料、生化、心电图、心脏超声等临床资料。按术中行基质电压标测所得的LVZ是否大于6%将患者分为A组(LVZ < 6%)和B组(LVZ ≥ 6%)。采用酶联免疫标记法检测患者血清CCN5的水平。采用t检验比较对照组/房颤组、A/B组CCN5表达水平。采用Pearson或Spearman相关性分析探索CCN5与各临床资料的相关性。通过Logistic回归分析确定影响低压区的危险因素，绘制受试者工作特征(ROC)曲线确定CCN5预测左房低电压的临界值。结果：房颤患者血清CCN5表达水平显著低于对照组(32.43 ± 6.15比25.46 ± 4.97，P < 0.001)。房颤患者CCN5与BNP水平、左房直径和左房低电压面积占比显著负相关(P < 0.05)。与A组相比，B组房颤患者CCN5表达水平更低(30.10 ± 6.75比24.75 ± 3.49，P < 0.001)。根据Logistic回归分析显示，血清CCN5水平降低确认为LVZ的独立危险因素。ROC曲线表明房颤患者血CCN5预测LVZ ≥ 6%的最佳血浓度为27.22 ng/ml，灵敏度为0.707，特异度为0.773，曲线下面积为0.785 [P < 0.001, CI: (0.696, 0.873)]。结论：血清CCN5可以独立预测房颤患者左房低电压面积占比。
Objective: To explore whether the serum CCN5 levels associated with atrial fibrosis can predict LVZ in patients with atrial fibrillation. Methods: In this study, 79 patients with sinus rhythm (control group) and 114 patients with atrial fibrillation (atrial fibrillation group) who received radiofrequency cardiac ablation for the first time in Yantai Yuhuangding Hospital between June 2023 and January 2024 were enrolled. General data, biochemistry, electrocardiogram, cardiac ultrasound and other clinical data were collected. Left atrial stroma voltage mapping was performed in patients with atrial fibrillation and LVZ area ratio was calculated. Patients were divided into group A (LVZ < 6%) and group B (LVZ ≥ 6%) according to whether LVZ was greater than 6%. The expression level of CCN5 in peripheral blood was measured by enzyme-linked immunosorbent assay. T test was used to compare the CCN5 expression level between the control group and the atrial fibrillation group. Pearson or Spearman correlation analysis was used to explore the correlation between CCN5 and clinical data. Binary Logistic regression analysis was used to determine the risk factors affecting the LVZ, and receiver operating characteristic (ROC) analysis was down to determine the cut-off value of CCN5 to predict LVZ. Results: The level of CCN5 in patients with atrial fibrillation was lower than in control group (32.43 ± 6.15 vs. 25.46 ± 4.97, P < 0.001). For atrial fibrillation patients with LVZ < 6%, blood CCN5 expression levels were lower in patients with LVZ ≥ 6% (30.10 ± 6.75 vs. 24.75 ± 3.49, P < 0.001). In patients with atrial fibrillation, CCN5 was negatively correlated with BNP level, left atrial diameter and left atrial low-voltage
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