广东医学2025，Vol.46Issue(11)：1735-1740,6.DOI:10.13820/j.cnki.gdyx.20251206
血清L1CAM、FABP4、NOX2水平与心脏瓣膜置换术患者术后新发心房颤动的关系及预测价值
Relationship and predictive value of serum L1CAM,FABP4,and NOX2 levels for postoperative atrial fibrillation in patients undergoing cardiac valve replacement
摘要
Abstract
Objective To investigate the relationship and predictive value of serum L1 cell adhesion molecule(L1 CAM),fatty acid-binding protein 4(FABP4),and NADPH oxidase 2(NOX2)levels in patients with valvular heart disease(VHD)undergoing cardiac valve replacement(CVR)who develop postoperative atrial fibrillation(POAF).Methods A total of 127 patients with VHD who underwent CVR between January 2023 and March 2025 were enrolled as the observation group.Based on electrocardiographic monitoring,they were divided into the POAF group(n=57)and non-POAF group(n=70).An additional 127 healthy volunteers were included as the normal control(NC)group.Ser-um levels of L1CAM,FABP4,and NOX2 were measured using ELISA.Multivariate logistic regression was applied to identify independent risk factors for POAF.Receiver operating characteristic(ROC)curves were used to evaluate the pre-dictive value of these biomarkers.Results Compared with the NC group,serum L1CAM levels were significantly de-creased,while FABP4 and NOX2 levels were significantly increased in VHD patients(P＜0.05).Compared with the non-POAF group,the POAF group showed larger left atrial diameter,higher proportion of NYHA class Ⅳ,increased FABP4 and NOX2 levels,and decreased L1CAM levels(all P＜0.05).High L1CAM expression was an independent pro-tective factor,whereas high FABP4 and NOX2 expression were independent risk factors for POAF(P＜0.05).The pre-dictive AUCs of L1CAM,FABP4,and NOX2 for POAF were 0.810,0.820,and 0.807,respectively,while their com-bined detection yielded a higher AUC of 0.950,superior to individual predictors(all P＜0.05).Conclusion Serum L1CAM is downregulated,whereas FABP4 and NOX2 are upregulated in VHD patients undergoing CVR.These three bio-markers are important determinants of POAF,and their combined detection demonstrates superior predictive value for post-operative risk stratification.关键词
心脏瓣膜置换术/术后新发心房颤动/L1-细胞黏附分子/脂肪细胞型脂肪酸结合蛋白4/NADPH氧化酶2Key words
cardiac valve replacement/postoperative atrial fibrillation/L1 cell adhesion molecule/fatty acid-binding protein 4/NADPH oxidase 2分类
医药卫生引用本文复制引用
高致炳,王登峰,韩冬,张超..血清L1CAM、FABP4、NOX2水平与心脏瓣膜置换术患者术后新发心房颤动的关系及预测价值[J].广东医学,2025,46(11):1735-1740,6.基金项目
河南省医学科技攻关计划(联合共建)项目(LHGJ202204016) （联合共建）
