结构重构相关因子对无结构性心脏病房颤患者左房结构重构程度的预测

目的:探讨无结构性心脏病房颤患者的左房或右房基质金属蛋白酶-9（MMP-9）、金属蛋白酶组织抑制因子-1（TIMP-1）、转化生长因子-β1（TGF-β1）和碱性成纤维细胞生长因子（bFGF）血清水平与心房结构重构的关系。方法: 通过ELISA方法检测42例无结构性心脏病房颤患者及17例阵发性室上速或预激综合征患者左房和右房中血清的MMP-9、TIMP-1、TGF-β1和bFGF水平，并使用超声心动图测量左心房长径。分析血清中上述细胞因子的水平与房颤左房结构重构程度的关系。结果: 房颤组左房内径(36±7) mm显著高于对照组(31±4) mm（P<0.01）；房颤组左房血清MMP-9为(3037±804) ng/L，明显高于对照组(2439±663) ng/L（P<0.01）和右房(2635±9308) ng/L（P<0.05），但右房血清MMP-9与对照组相比未见显著性差异；与对照组相比，房颤组TIMP-1明显降低（P<0.05），TGF-β1明显升高（P<0.01），bFGF无显著性差异；MMP-9/TIMP-1与左房内径呈正相关。结论: MMP-9、TIMP-1和TGF-β1与房颤相关，并可提示房颤的结构重构程度。

Structural remodeling-related factors can predict structural remodeling of left atrium in patients with atrial fibrillation without structural heart disease

AIM: To investigate the significance of matrix metalloproteinases-9(MMP-9),tissue inhibitor of metalloproteinase-1(TIMP-1),transforming growth factor-beta 1(TGF-β1) and basic fibroblast growth factor(bFGF) serum level related to atrial structural remodeling in atrial fibrillation(AF) patients without structural heart disease.METHODS: Serum samples were taken from,respectively,left atrium and right atrium of 42 AF patients without structural heart disease and 17 paroxysmal supraventricular tachycardia or patients with Wolff-Parkinson-White(WPW) syndrome who underwent catheter ablation.Pre-ablation plasma concentrations of MMP-9,TIMP-1,TGF-β1 and bFGF were evaluated by ELISA.Left atrial diameter(LAD) was detected by echocardiography.RESULTS: LAD in AF group(36±7) mm was statistically higher than in control group(31±4) mm.MMP-9 serum level of the left atrium in the AF group(3037±804) pg/ml was statistically higher than in the control group(2439±663) pg/ml(P<0.01) and the level in the right atrium(2635±930.38) pg/ml(P<0.05).Right atrium MMP-9 levels in the AF group(2635.35±930.38) pg/ml were similar to the control group(2762.34±802.53) pg/ml(P>0.05).TIMP-1 level in AF group was statistically lower than in control group(P<0.05) and TGF-β1 level in the AF group was statistically higher than control group(P<0.05).No significant difference in bFGF level was found between AF and control groups.MMP9 serum level and LAD in AF group was linearly correlated(0.447,P<0.01).CONCLUSIONS: MMP-9,TIMP-1 and TGF-β1 are closely related to the occurrence of AF and can be used to predict the structural remodeling of left atrium in patients with AF.