尧华杰,张元淋,彭 清

目的：比较非瓣膜性心房颤动患者与对照组人群血清镍纹样蛋白（Metrnl）水平的差异，并探讨其与胰岛素抵抗及炎症反应的相关性。方法：纳入2025年1月至9月西南医科大学附属医院心血管内科住院患者140例，按是否合并心房颤动分为心房颤动组与对照组。收集临床资料、实验室指标及超声心动图参数，行单因素及二元Logistic回归分析。结果：两组在年龄、心率、收缩压（SBP）、左心房内径（LAD）、左心室收缩末期内径（LVDs）、D-二聚体、淋巴细胞绝对值、中性粒细胞百分数、尿素、白蛋白、肾小球滤过率、肌钙蛋白（cTnT）、N末端B型利钠肽前体(NT-proBNP)、超敏C反应蛋白（Hs-CRP）及血清Metrnl水平等方面差异均有统计学意义（P＜0.05）。血清Metrnl水平与心率、中性粒细胞百分数、D-二聚体、尿素、NT-proBNP、LAD、左心室舒张末期内径（LVDD）、LVDs、Hs-CRP及TYG指数呈负相关（P＜0.05），与左心室射血分数（LVEF）呈正相关（P＜0.05）。多因素Logistic回归提示，LAD、HsCRP与血清Metrnl水平是心房颤动的独立相关因素（P＜0.05）。结论：血清Metrnl水平与胰岛素抵抗和炎症反应密切相关，可能通过上述机制参与心房颤动的发生发展。Metrnl为心房颤动的保护性因素，可作为预测心房颤动发生的潜在生物学标志物。

心房颤动；Meteorin-like蛋白；胰岛素抵抗；超敏Ｃ－反应蛋白

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