实用临床医药杂志2026，Vol.30Issue(10)：51-57,7.DOI:10.7619/jcmp.20260610
血清乙酰肝素酶、三甲胺N-氧化物与非瓣膜性房颤患者左心耳血栓形成的关系及预测效能
Relationship and predictive value of serum heparanase and trimethylamine N-oxide in left atrial appendage thrombosis among patients with non-valvular atrial fibrillation
摘要
Abstract
Objective To investigate the correlations of serum heparanase(HPA)and trimeth-ylamine N-oxide(TMAO)with left atrial appendage thrombosis(LAAT)formation in patients with non-valvular atrial fibrillation(NVAF),and to evaluate their predictive efficacy.Methods A total of 297 NVAF patients were enrolled as NVAF group,and 123 age-matched healthy subjects undergo-ing routine physical examinations during the same period were enrolled as control group.Serum HPA and TMAO levels were measured by enzyme-linked immunosorbent assay(ELISA).Transesophageal echocardiography was performed to determine the presence of LAAT,and NVAF patients were classi-fied into LAAT group and non-LAAT group.The influencing factors for LAAT formation in NVAF pa-tients and the predictive value of serum HPA and TMAO levels were analyzed.Results Serum HPA and TMAO levels in the NVAF group were significantly higher than those in the control group(P＜0.001).Significant differences were observed between the LAAT group(n=98)and non-LAAT group(n=199)in age,proportion of heart failure,proportion of persistent NVAF,CHA2DS2-VASc score,left atrial diameter(LAD)and N-terminal pro-B-type natriuretic peptide(NT-proBNP)(P＜0.05).Serum HPA and TMAO levels in the LAAT group were significantly higher than those in the non-LAAT group(P＜0.001).Multivariate logistic regression analysis revealed that increas-ing age(OR=1.039,95％CI:1.002 to 1.078,P=0.038),persistent NVAF(OR=4.564,95％CI:2.004 to 10.399,P＜0.001),higher CHA2DS2-VASc score(OR=2.135,95％CI:1.534 to 2.970,P＜0.001),increased LAD(OR=1.160,95％CI:1.070 to 1.259,P＜0.001),elevated HPA(OR=1.177,95％CI:1.109 to 1.248,P＜0.001)and elevated TMAO(OR=2.455,95％CI:1.733 to 3.477,P＜0.001)were independent risk factors for LAAT for-mation in NVAF patients.The area under the receiver operating characteristic(ROC)curve for the combined prediction of LAAT formation by serum HPA and TMAO levels was 0.870,which was sig-nificantly higher than that of HPA alone(0.767)or TMAO alone(0.799)(P＜0.001).Conclu-sion Elevated serum HPA and TMAO levels are independent risk factors for LAAT formation in NVAF patients.The combined prediction of HPA and TMAO levels demonstrates high efficacy and serve as novel auxiliary predictive biomarker for LAAT formation in NVAF patients.关键词
非瓣膜性房颤/乙酰肝素酶/三甲胺N-氧化物/左心耳血栓/左心房内径/影响因素/预测效能/受试者工作特征曲线Key words
non-valvular atrial fibrillation/heparanase/trimethylamine N-oxide/left atrial ap-pendage thrombosis/left atrial diameter/influencing factors/predictive value/receiver operating characteristic curve分类
医药卫生引用本文复制引用
田韵,何河,龚杰..血清乙酰肝素酶、三甲胺N-氧化物与非瓣膜性房颤患者左心耳血栓形成的关系及预测效能[J].实用临床医药杂志,2026,30(10):51-57,7.基金项目
宁夏回族自治区卫生健康委科研项目(2023-NWKYP-053) （2023-NWKYP-053）
