JP2与原发性高血压患者心房颤动的相关性

doi:10.3969/j.issn.1004-583X.2025.06.004

摘要/Abstract

摘要：

目的探讨连接蛋白2(junctophilin 2,JP2)与原发性高血压(essential hypertension,EH)患者心房颤动(atrial fibrillation,AF)的相关性。方法选取2019-2022年于河北省人民医院心血管内科住院的EH患者127例,根据是否合并AF分为EH+AF组(n=52)和EH组(n=75)。比较两组临床资料,采用logistic回归分析EF患者发生AF的危险因素,通过受试者工作特征曲线评估JP2和左心房直径(left atrial diameter,LAD)预测EH患者发生AF的价值。结果 ①与EH组相比,EH+AF组年龄、N末端B型脑钠肽前体更高,估算肾小球滤过率、JP2、左心室射血分数更低,LAD、左心室收缩末期内径均更大,差异均有统计学意义(P<0.05)。②单因素logistic回归分析显示,年龄、N-末端B型脑钠肽前体、LAD、左心室舒张末期内径是EH患者发生AF的危险因素,估算肾小球滤过率、JP2和左心室射血分数是EH患者发生AF的保护因素,差异均有统计学意义(P<0.05);多因素logistic回归分析显示,LAD是EH患者发生AF的独立危险因素,JP2是EH患者发生AF的独立保护因素,差异均有统计学意义(P<0.05)。③受试者工作特征曲线显示,JP2识别EH患者发生AF的AUC为0.825(95%CI:0.753~0.897,P<0.001),敏感度为92.3%,特异度为68.5%。LAD识别EH患者发生AF的AUC为0.805(95%CI:0.724~0.886,P<0.001),敏感度为80.8%,特异度为67.1%。JP2联合LAD识别EH患者AF的AUC为0.918(95%CI:0.871~0.964,P<0.001),敏感度为86.5%,特异度为84.9%。结论 EH患者JP2降低与LAD扩大与AF相关,两者联合可更好地预测AF。

关键词: 原发性高血压, 心房颤动, 连接蛋白2, 左心房直径

Abstract:

Objective To investigate the correlation between junctophilin 2 (JP2) and atrial fibrillation (AF) in patients with essential hypertension (EH). Methods A total of 127 EH patients hospitalized in the Department of Cardiology, Hebei General Hospital from 2019 to 2022 were selected. They were divided into the EH + AF group (n=52) and EH group (n=75) according to whether they were complicated with AF. The clinical data of the two groups were compared. Logistic regression was used to analyze the risk factors of AF in EF patients. The value of JP2 and left atrial diameter (LAD) in predicting AF in EH patients was evaluated by the receiver operating characteristic (ROC) curve. Results Compared with the EH group, patients in the EH+AF group had significantly older age, higher N-terminal B-type natriuretic peptide (NT-proBNP), LAD and left ventricular end-systolic diameter (LVESD), but lower estimated glomerular filtration rate (eGFR), JP2 and left ventricular ejection fraction (LVEF) (P<0.05). Univariate logistic regression analysis showed that age, NT-proBNP, LAD and LVEDD were risk factors for AF in EH patients, while eGFR, JP2 and LVEF were protective factors for AF in EH patients (P<0.05). Multivariate logistic regression analysis showed that LAD was an independent risk factor for AF in EH patients, and JP2 was an independent protective factor for AF in EH patients (P<0.05). The ROC curve showed that the area under the curve (AUC) of JP2 in identifying AF in EH patients was 0.825 (95%CI: 0.753-0.897, P<0.001), with a sensitivity of 92.3%, and a specificity of 68.5%. The AUC of LAD in identifying AF in EH patients was 0.805(95%CI: 0.724-0.886, P<0.001), with a sensitivity of 80.8%, and a specificity of 67.1%. The AUC of JP2 combined with LAD in identifying AF in EH patients was 0.918(95%CI: 0.871-0.964, P<0.001), with a sensitivity of 86.5%, and a specificity of 84.9%. Conclusion Decreased JP2 in EH patients is related to the enlargement of LAD and AF, and the combination of JP2 and LAD can better predict AF in EH patients.

Key words: essential hypertension, atrial fibrillation, junctophilin-2, left atrial diameter

中图分类号:

R544.1

司会莉, 郭爽, 董浩铖, 李树仁. JP2与原发性高血压患者心房颤动的相关性[J]. 临床荟萃, 2025, 40(6): 504-508.

Si Huili, Guo Shuang, Dong Haocheng, Li Shuren. Correlation of JP2 with atrial fibrillation in patients with essential hypertension[J]. Clinical Focus, 2025, 40(6): 504-508.

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https://lchc.magtechjournal.com/CN/Y2025/V40/I6/504

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参考文献 25

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项目	EH+AF组(n=52)	EH组(n=75)	χ²/t/Z值	P值
年龄(岁)	70.1±11.3	64.2±12.4	-3.042	0.003
女性[例(%)]	27(51.9)	40(53.3)	0.025	0.876
BMI(kg/m²)	26.2(4.6)	26.0(4.4)	-0.691	0.489
饮酒史[例(%)]	12(23.1)	10(13.3)	2.036	0.154
吸烟史[例(%)]	15(28.8)	14(18.7)	1.806	0.179
糖尿病史[例(%)]	12(23.1)	28(37.3)	2.893	0.089
冠心病史[例(%)]	24(46.2)	40(53.3)	0.633	0.426
空腹血糖(mmol/L)	5.4(1.0)	5.1(1.6)	-1.897	0.058
尿酸(μmol/L)	333.8(102.0)	310.9(111.4)	-1.657	0.097
LDL-C(mmol/L)	2.3(1.2)	2.7(1.0)	-1.630	0.103
eGFR(ml/min)	80.4(23.3)	91.4(14.5)	-3.731	<0.001
WBC(×10⁹/L)	6.4(2.4)	6.1(2.3)	-0.613	0.540
HB(g/L)	135.3±17.8	134.6±16.2	0.220	0.826
NT-proBNP (ng/L)	278.0(720.0)	71.0(69.0)	-5.334	<0.001
JP2 (ng/L)	43.8(11.0)	60.3(24.3)	-6.306	<0.001
LAD (mm)	44(7)	38(5)	-5.812	<0.001
LVESD (mm)	31.0(4.0)	29.5(5.0)	-2.635	0.008
LVEDD (mm)	47.0(7.0)	46.5(5.0)	-1.367	0.171
LVEF (%)	62.0(5.0)	65.0(6.8)	-2.785	0.005

项目	EH+AF组(n=52)	EH组(n=75)	χ²/t/Z值	P值
年龄(岁)	70.1±11.3	64.2±12.4	-3.042	0.003
女性[例(%)]	27(51.9)	40(53.3)	0.025	0.876
BMI(kg/m²)	26.2(4.6)	26.0(4.4)	-0.691	0.489
饮酒史[例(%)]	12(23.1)	10(13.3)	2.036	0.154
吸烟史[例(%)]	15(28.8)	14(18.7)	1.806	0.179
糖尿病史[例(%)]	12(23.1)	28(37.3)	2.893	0.089
冠心病史[例(%)]	24(46.2)	40(53.3)	0.633	0.426
空腹血糖(mmol/L)	5.4(1.0)	5.1(1.6)	-1.897	0.058
尿酸(μmol/L)	333.8(102.0)	310.9(111.4)	-1.657	0.097
LDL-C(mmol/L)	2.3(1.2)	2.7(1.0)	-1.630	0.103
eGFR(ml/min)	80.4(23.3)	91.4(14.5)	-3.731	<0.001
WBC(×10⁹/L)	6.4(2.4)	6.1(2.3)	-0.613	0.540
HB(g/L)	135.3±17.8	134.6±16.2	0.220	0.826
NT-proBNP (ng/L)	278.0(720.0)	71.0(69.0)	-5.334	<0.001
JP2 (ng/L)	43.8(11.0)	60.3(24.3)	-6.306	<0.001
LAD (mm)	44(7)	38(5)	-5.812	<0.001
LVESD (mm)	31.0(4.0)	29.5(5.0)	-2.635	0.008
LVEDD (mm)	47.0(7.0)	46.5(5.0)	-1.367	0.171
LVEF (%)	62.0(5.0)	65.0(6.8)	-2.785	0.005

自变量	单因素logistic回归分析			多因素logistic回归分析
自变量	OR值	95%CI	P值	OR值	95%CI	P值
年龄	1.048	1.015~1.082	0.004	0.989	0.937~1.044	0.685
eGFR	-0.959	0.936~0.983	0.001	-0.997	0.959~1.036	0.864
NT-proBNP	1.005	1.002~1.007	<0.001	1.002	0.999~1.005	0.179
JP2	-0.912	0.881~0.944	<0.001	-0.901	0.860~0.944	<0.001
LAD	1.300	1.173~1.441	<0.001	1.339	1.130~1.586	0.001
LVESD	1.155	1.039~1.284	0.008	0.957	0.778~1.177	0.676
LVEF	-0.906	0.843~0.974	0.007	-0.902	0.795~1.023	0.109

自变量	单因素logistic回归分析			多因素logistic回归分析
自变量	OR值	95%CI	P值	OR值	95%CI	P值
年龄	1.048	1.015~1.082	0.004	0.989	0.937~1.044	0.685
eGFR	-0.959	0.936~0.983	0.001	-0.997	0.959~1.036	0.864
NT-proBNP	1.005	1.002~1.007	<0.001	1.002	0.999~1.005	0.179
JP2	-0.912	0.881~0.944	<0.001	-0.901	0.860~0.944	<0.001
LAD	1.300	1.173~1.441	<0.001	1.339	1.130~1.586	0.001
LVESD	1.155	1.039~1.284	0.008	0.957	0.778~1.177	0.676
LVEF	-0.906	0.843~0.974	0.007	-0.902	0.795~1.023	0.109