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目的:研究孤立性房颤(lone atrial fibrillation,LAF)患者不对称二甲精氨酸水平(asymmetric dimethylarginine,ADMA)的变化,探讨其内皮功能损害的特点。方法:选取在2014年12月—2017年1月80例符合入组条件的LAF病例为LAF组,选择同期体检的窦性心律志愿者80例为对照组。所有病例均以酶联免疫吸附双抗体夹心法(ELISA)检测ADMA水平。结果:两组在年龄、性别等临床资料比较,差异无统计学意义(P>0.05),LAF组静息心率、体重指数、左房内径、ADMA大于对照组,差异有统计学意义(P<0.05);对于所有研究对象多因素回归分析提示房颤、心率、吸烟、胆固醇值是预测ADMA升高的独立危险因素(P<0.01);对于LAF组病例多因素回归分析提示房颤持续时间、吸烟、胆固醇值是预测ADMA升高的独立危险因素(P<0.05或0.01)。结论:LAF同样可以引起全身血管内皮损害;房颤持续时间、吸烟、胆固醇值是房颤患者内皮功能受损程度的重要预测因子。
Objective: To investigate the changes of asymmetric dimethylarginine (ADMA) in patients with lone atrial fibrillation (LAF) and to explore the characteristics of endothelial dysfunction. Methods: From December 2014 to January 2017, 80 cases of LAF who met the inclusion criteria were selected as the LAF group and 80 cases of sinus rhythm volunteers selected as the control group during the same period. All cases were detected by enzyme-linked immunosorbent double antibody sandwich method (ELISA) ADMA levels. Results: There was no significant difference in age, sex and other clinical data between the two groups (P> 0.05). Resting heart rate, body mass index, left atrium diameter and ADMA in LAF group were significantly higher than those in control group (P < 0.05). Multiple regression analysis showed that atrial fibrillation, heart rate, smoking and cholesterol were independent predictors of ADMA (P <0.01). Multiple regression analysis showed that the duration of atrial fibrillation (AF) Smoking, cholesterol values were independent predictors of ADMA elevation (P <0.05 or 0.01). CONCLUSION: LAF can also cause systemic vascular endothelial damage; duration of AF, smoking, and cholesterol levels are important predictors of endothelial dysfunction in patients with AF.