血清sST2和hs-CRP对NVAF发生、转复成功及复发的预测价值

摘要/Abstract

摘要： 目的本研究探讨血清可溶性生长刺激表达基因2蛋白（sST2）和高敏C反应蛋白（hs-CRP）在非瓣膜性房颤（NVAF）发生、转复成功及复发中的预测价值。方法回顾性选取2021年—2024年齐齐哈尔医学院附属第二医院住院的冠心病、高血压病、心力衰竭患者共1 000例,按是否合并非瓣膜性房颤分组,并对接受复律治疗的患者进一步分组分析,收集sST2、hs-CRP及相关临床指标。结果冠心病合并非瓣膜性房颤患者的sST2、hs-CRP水平、左房前后径（LAD）高于冠心病未合并非瓣膜性房颤患者,差异有统计学意义（P<0.05）。高血压非瓣膜性病合并房颤患者的sST2、hs-CRP、LAD水平高于高血压病未合并非瓣膜性房颤患者,差异有统计学意义（P<0.05）。心力衰竭合并非瓣膜性房颤患者的sST2、hs-CRP、LAD水平高于心力衰竭未合并非瓣膜性房颤患者,差异有统计学意义（P<0.05）。不同病种的总转复成功患者的sST2水平低于不同病种的总未转复成功患者,差异有统计学意义（P<0.05）。不同病种的总转复成功患者的hs-CRP水平低于不同病种的总未转复成功患者未转复成功组,差异有统计学意义（P<0.05）。不同病种的转复成功后复发组的sST2水平高于不同病种的转复成功后未复发组,差异有统计学意义（P<0.05）。不同病种的转复成功后复发组的hs-CRP水平高于未复发组,差异有统计学意义（P<0.05）。结论 sST2水平可能反映心肌纤维化,hs-CRP水平则提示炎症状态,二者共同影响非瓣膜性房颤的发生及结局,监测sST2和hs-CRP水平有助于评估病情,指导个体化治疗,并为非瓣膜性房颤精准诊疗提供生物标志物依据。

关键词: 非瓣膜性房颤, 可溶性生长刺激表达基因2蛋白, 高敏C反应蛋白, 心肌纤维化, 炎症标志物

Abstract: Objective To investigate the predictive value of serum soluble growth-stimulated expressed gene 2 protein (sST2) and highly sensitive C-reactive protein (hs-CRP) in the occurrence, success and recurrence of nonvalvular atrial fibrillation (NVAF). Methods 1 000 patients with coronary heart disease, hypertension and heart failure admitted to the Second Affiliated Hospital of Qiqihar Medical College from 2021 to 2024 were retrospectively selected and grouped according to whether they were combined with nonvalvular atrial fibrillation. Patients receiving cardioversion therapy were further grouped and analyzed to collect sST2, hs-CRP and related clinical indicators. Results sST2, hs-CRP and left anteroposterior atrial diameter(LAD) in patients with coronary heart disease and AF were higher than those without AF, the difference was statistically significant (P<0.05). sST2, hs-CRP and LAD in hypertensive patients with nonvalvular atrial fibrillation were higher than those in hypertensive patients without nonvalvular atrial fibrillation, and the difference was statistically significant (P<0.05). sST2, hs-CRP and LAD in patients with heart failure and nonvalvular atrial fibrillation were higher than those without heart failure and the difference was statistically significant (P<0.05). The level of sST2 in patients with successful total recovery of different diseases was lower than that of patients without successful total recovery of different diseases, and the difference was statistically significant (P<0.05). The hs-CRP level of patients with different disease types with successful total recovery was lower than that of patients with different disease types without successful total recovery, and the difference was statistically significant (P<0.05). The level of sST2 in the relapse group of different diseases was higher than that in the non-relapse group of different diseases, and the difference was statistically significant (P<0.05). The level of hs-CRP in the relapsed group was higher than that in the non-relapsed group, and the difference was statistically significant (P<0.05). Conclusions ST2 may reflect myocardial fibrosis, while hs-CRP may indicate inflammation, which jointly affect the occurrence and outcome of nonvalvular atrial fibrillation. Monitoring sST2 and hs-CRP levels is helpful to evaluate the condition, guide individualized treatment, and provide biomarker basis for accurate diagnosis and treatment of nonvalvular atrial fibrillation.

Key words: nonvalvular atrial fibrillation, soluble growth-stimulated expressed gene 2 protein, highly sensitive C-reactive protein, myocardial fibrosis, inflammatory marker

中图分类号:

R540.4

张鑫蕊, 宗浩, 韩冬雪, 韩文雪, 李懿桐, 蔡彧, 王奕璁, 张琳, 王艳丽. 血清sST2和hs-CRP对NVAF发生、转复成功及复发的预测价值[J]. 中华养生保健, 2025, 43(12): 1-6.

ZHANG Xin-rui, ZONG Hao, HAN Dong-xue, HAN Wen-xue, LI Yi-tong, CAI Yu, WANG Yi-cong, ZHANG Lin, WANG Yan-li. Prognostic Value of Serum sST2 and hs-CRP in the Occurrence, Success and Recurrence of NVAF[J]. ZHONGHUA YANGSHENG BAOJIAN, 2025, 43(12): 1-6.

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