作者：任佩欣，武亚琳，樊钰，林鑫，杨慧宇

单位：

030000 山西省太原市，山西医科大学第二医院心内科；通信作者：杨慧宇，E-mail：yanghuiyu2010@126.com

关键词：

心房颤动；转化生长因子 -β；Periostin 蛋白；关系

Keywords：

Atrial fibrillation；TGF-β；Periostin protein；Relationship

CLC：

R 541.75

DOI：

DOI：10.3969/j.issn.1008-5971.2020.04.006

Funds：

国家自然科学基金资助项目（81700407）

摘要：

背景　Periostin 蛋白是一种高度保守的功能蛋白，目前关于血清 Periostin 蛋白与非瓣膜性心房颤动关系的研究较少。目的　探讨血清转化生长因子 β（TGF-β）、Periostin 蛋白水平与非瓣膜性心房颤动的关系及其作用机制。方法　将 2018 年 3 月—2019 年 3 月山西医科大学第二医院收治的非瓣膜性心房颤动患者 61 例作为试验组，另选取同期健康体检者 27 例为对照组。比较两组受试者性别、年龄、个人史（包括吸烟、饮酒）、既往史（包括高血压、糖尿病）、实验室检查指标〔总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、TGF-β、Periostin 蛋白〕及左心房内径；血清 TGF-β、Periostin 蛋白水平及左心房内径间的相关性采用 Pearson 相关性分析；非瓣膜性心房颤动影响因素分析采用多因素 Logistic 回归分析。结果　试验组患者血清 TGF-β、Periostin 蛋白水平高于对照组，左心房内径大于对照组（P<0.05）。Pearson 相关性分析结果显示，非瓣膜性心房颤动患者血清TGF-β 水平与 Periostin 蛋白水平（r=0.366）、左心房内径（r=0.302）呈正相关（P<0.05），Periostin 蛋白水平与左心房内径呈正相关（r=0.320，P<0.05）。多因素Logistic回归分析结果显示，血清TGF-β水平〔OR=1.001，95CI（1.000，1.002）〕、左心房内径〔OR=0.780，95%CI（0.682，0.891）〕是非瓣膜性心房颤动的独立影响因素（P<0.05）。结论　非瓣膜性心房颤动患者血清 TGF-β 水平与 Periostin 蛋白水平呈正相关，且血清 TGF-β 水平是非瓣膜性心房颤动的独立影响因素，进一步推测 TGF-β 可能通过促进 Periostin 蛋白分泌而导致心肌纤维化，且二者还可能通过影响心房重构而引发非瓣膜性心房颤动。

Abstract：

Background　Periostin protein is a highly conserved functional protein.However，there are fewer researchon Periostin protein and non-valvular atrial fibrillation. Objective　To discuss the relationship between serum levels of TGF-βand Periostin protein and non-valvular atrial fibrillation and its mechanism. Methods　A total of 61 cases of patients with non-valvular atrial fibrillation in Second Hospital of Shanxi Medical University from March 2018 to March 2019 as experimentalgroup，and 27 healthy controls were selected as control group.Gender，age，personal history（including smoking，drinking），previous history（including hypertension，diabetes），laboratory indicators（including TC，TG，HDL，LDL，TGF-β，Periostin protein） and left atrial diameter were compared between the two groups. Pearson correlation analysis wasused to investigate the correlation in serum TGF-β，Periostin protein and left atrial diameter；multivariate Logistic regressionanalysis was used to analyze the influencing factors of non-valvular atrial fibrillation. Results　Serum levels of TGF-β，Periostin protein in experimental group were higher than those in control group，left atrial diameter in experimental group wasbigger than that in control group（P<0.05）. Pearson correlation analysis showed that，serum TGF-β level was positivelycorrelated with Periostin protein （r=0.366），left atrial diameter （r=0.302），respectively （P<0.05），Periostin proteinlevel was positively correlated with left atrial diameter （r=0.320，P<0.05） in patinets with nonvalvular atrial fibrillation.Multivariate Logistic regression analysis showed that，serum TGF-β level 〔OR=1.001，95CI（1.000，1.002）〕，left atrialdiameter 〔OR=0.780，95%CI （0.682，0.891）〕 were independent influencing factors of non-valvular atrial fibrillation（P<0.05）.Conclusion　Periostin protein is positively correlated with TGF-βin patients with non-valvular atrial fibrillation，and serumTGF-β level is influencing factor of non-valvular atrial fibrillation.It is further speculated that TGF-β may induce myocardialfibrosis by promoting secretion of Periostin protein，and they may also cause non-valvular atrial fibrillation by affecting atrialremodeling.

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