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-B1(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。
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) pa- tients 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 supraventric- ular tachycardia or patients with Wolff-Parkinson-White (WPW) syndrome who underwent catheter abla- tion. Pre-ablation plasma concentrations of MMP-9, TIMP-1, TGF-βI 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