血清PTGS1、MYL4水平在心房颤动患者中的表达及其与血栓栓塞风险的相关性OA
Expression of peripheral blood PTGS1 and MYL4 in patients with atrial fibrillation and its correlation with thrombo-embolic risk
目的 探讨血清前列腺素内过氧化物合酶1(PTGS1)、肌球蛋白轻链4(MYL4)水平在心房颤动(AF)患者中的表达及其与血栓栓塞(TE)风险的相关性.方法 选取2022年1月—2024年2月延安大学附属医院心血管病中心收治的AF患者125例为AF组,按照1∶1比例选取同期健康体检志愿者125例为健康对照组,随访1年根据是否发生TE事件将AF患者分为TE亚组38例和非TE亚组87例.采用酶联免疫吸附法检测血清PTGS1、MYL4水平;Spearman相关性分析AF患者血清PTGS1、MYL4水平与CHA2DS2-VASc评分的相关性;多因素Logistic回归分析AF患者发生TE的影响因素;受试者工作特征(ROC)曲线分析血清PTGS1、MYL4水平对AF患者发生TE的预测效能.结果 与健康对照组比较,AF组血清PTGS1水平升高,MYL4水平降低(t/P=13.543/＜0.001、12.316/＜0.001);随访1年,125例AF患者的TE事件发生率为30.40％(38/125).与非TE亚组比较,TE亚组年龄大,糖尿病、慢性心力衰竭、IS/TIA史比例及CHA2DS2-VASc评分、血清PTGS1水平高,血清MYL4水平低(t/x2/P=3.010/0.003、4.848/0.028、7.430/0.006、10.944/0.001、8.009/＜0.001、5.796/＜0.001、5.738/＜0.001);Spearman 相关分析显示,AF 患者血清PTGS1水平与CHA2DS2-VASc评分呈正相关(rs/P=0.702/＜0.001),血清MYL4水平与CHA2DS2-VASc评分呈负相关(rs/P=-0.678/＜0.001);多因素Logistic回归分析显示,年龄大、IS/TIA史、CHA2DS2-VASc评分高、血清PTGS1水平高为 AF 患者发生 TE 的独立危险因素[OR(95％CI)=1.154(1.035～1.286)、3.663(1.578～8.500)、1.857(1.316～2.620)、2.335(1.481～3.681)],血清 MYL4 水平高为独立保护因素[OR(95％CI)=0.864(0.801～0.931)];血清 PTGS1、MYL4水平单独及二者联合预测AF患者发生TE的曲线下面积(AUC)分别为0.812、0.775、0.894,二者联合优于单独预测(Z/P=2.726/0.006、3.367/0.001).结论 AF患者血清PTGS1水平升高、MYL4水平降低,且与TE风险增加密切相关,血清PTGS1、MYL4水平联合对AF患者TE风险的预测效能较高.
Objective To investigate the expression of prostaglandin-endoperoxide synthase 1(PTGS1)and myosin light chain 4(MYL4)in peripheral blood of patients with atrial fibrillation(AF),and their correlation with thromboembolic(TE)risk.Methods A prospective study enrolled 125 AF patients admitted to the Cardiovascular Center of Yan'an Universi-ty Affiliated Hospital from January 2022 to February 2024(AF group)and 125 age-and sex-matched healthy volunteers(con-trol group)at a 1∶1 ratio.AF patients were followed for 1 year and divided into TE and non-TE subgroups according to the occurrence of TE events.Peripheral blood PTGS1 and MYL4 levels were measured by enzyme-linked immunosorbent assay.Spearman correlation analysis was performed to assess the relationship between PTGS1,MYL4 levels and CHA2DS2-VASc scores in AF patients.Multivariate logistic regression and receiver operating characteristic(ROC)curve analysis were used to evaluate the association and predictive value of PTGS1 and MYL4 levels for TE risk in AF patients.Results Compared with the control group,AF patients exhibited higher PTGS1 and lower MYL4 levels in peripheral blood(t=13.543,-12.316;both P＜0.001).During the 1-year follow-up,the incidence of TE events in AF patients was 30.40％(38/125).Compared with the non-TE subgroup,patients in the TE subgroup were older,had a higher prevalence of diabetes,heart failure,prior IS/TIA,higher CHA2DS2-VASc scores,elevated PTGS1,and decreased MYL4 levels(x2/t=3.010,4.848,7.430,10.944,8.009,5.796,-5.738;P=0.003,0.028,0.006,0.001,＜0.001,＜0.001,＜0.001).PTGS1 levels were positively correlated with CHA2DS2-VASc scores,while MYL4 levels were negatively correlated(rs=0.702,-0.678;both P＜0.001).Advanced age,pri-or IS/TIA,high CHA2DS2-VASc score,and elevated PTGS1 were independent risk factors for TE in AF patients,whereas higher MYL4 was an independent protective factor[OR(95％CI)=1.154(1.035-1.286),3.663(1.578-8.500),1.857(1.316-2.620),2.335(1.481-3.681),0.864(0.801-0.931)].The area under the curve(AUC)for PTGS1,MYL4,and their combina-tion in predicting TE risk were 0.812,0.775,and 0.894,respectively,with the combined prediction significantly superior to ei-ther marker alone(Z=2.726,3.367;both P＜0.001).Conclusion Elevated peripheral blood PTGS1 and decreased MYL4 lev-els are associated with increased TE risk in AF patients.The combined assessment of PTGS1 and MYL4 provides higher pre-dictive efficacy for TE events.
安荣;茂建梅;杨铠榕;李智;毕云
716000 陕西延安,延安大学附属医院心血管病中心716000 陕西延安,延安大学附属医院心血管内科716000 陕西延安,延安大学附属医院心血管内科716000 陕西延安,延安大学附属医院心血管内科716000 陕西延安,延安大学附属医院心血管内科
医药卫生
心房颤动血栓栓塞前列腺素内过氧化物合酶1肌球蛋白轻链4预测
Atrial fibrillationThromboembolismProstaglandin-endoperoxide synthase 1Myosin light chain 4Prediction
《疑难病杂志》 2026 (1)
2-7,6
陕西省科技计划项目(2021JQ-726) Shaanxi Provincial Science and Technology Plan Project(2021JQ-726)
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