目的:探讨转化生长因子-β1(TGF-β1)、基质金属蛋白酶-9(MMP-9)、金属蛋白酶组织抑制因子-1(TIMP-1)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、白介素-10(IL-10)与阵发性或持续性房颤结构重构的关系。方法:入选患者分为3组,其中持续性房颤组30例、阵发性房颤组45例,以及32例阵发性室上速(包括预激综合征)作为对照组,通过ELISA方法检测上述患者左房血清的TGF-β1、MMP-9、TIMP-1、TNF-α、IL-6、IL-10水平,超声测量左心房长径。分析上述细胞因子水平与阵发性房颤或持续性房颤的关系。结果:阵发性房颤组与对照组相比,左房内径增大、TGF-β1、TNF-α升高(P〈0.05),IL-10、TIMP-1降低(P〈0.05),MMP-9无统计学差异。持续性房颤组与对照组相比,TGF-β1无统计学差异(P〉0.05),MMP-9、TNF-α、IL-6均升高(P〈0.05),IL-10、TIMP-1降低(P〈0.05);阵发性房颤组TGF-β1高于持续性房颤组(P〈0.05),持续性房颤组左房内径及MMP-9高于阵发性房颤组(P〈0.05)。结论:阵发性房颤患者左房扩大,已出现结构重构,结构重构的血清学变化以TGF-β1升高为主;持续性房颤患者结构重构血清学变化以MMP-9、IL-6升高为主。
Objective: To investigate the relationship of TGF-β1, MMP-9, TIMP-1, TNF-α, IL-6, IL-10 with paroxysmal atrial fibrillation(AF) or persistent AF. Methods: The patients was divided into three groups, including 45 paroxysmal AF patients, 30 persistent AF patients and a control group of 32 paroxysmal suprawentricular tachycardia or WPW patients who underwent catheter ablation, Serum samples were respectively taken from left atrium of these patients and, the pre-ablation plasma concentrations of TGF-β1, MMP-9,TIMP-1, TNF-α, IL-6, IL-10 were evaluated by ELISA. The left atrial diameter(LAD) was detected by echocardiography. Results:Paroxysmal AF group compared with control group, the level of LAD, TGF-β1, TNF-α was increased(P〈0.05), the level of IL- 10 and TIMP- 1 was lower(P〈0.05), and MMP- 9 had no statistical difference(P〈0.05). Persistent AF group compared with control group, the level of TGF-β1 had no statistical difference(P〈0.05), the level of MMP- 9, TNF-α, IL- 6 was higher(P〈0.05), and IL- 10 and TIMP-1 was lower(P〈0.05). Comparison between paroxysmal AF group and persistent AF group, the levels of TGF-β1 in paroxysmal AF group was higher, LAD and the level of MMP- 9 was lower than that of persistent AF group(P〈0.05). Conclusions: Patients with paroxysmal AF already have structural remodeling, left atrial dilated, and the serum changes of structural remodeling are given priority to elevated TGF-β1, while the serum changes of structural remodeling in persistent AF are given priority to elevated MMP- 9 and IL- 6.