老年心房颤动患者胶原代谢与基质金属蛋白酶表达的研究  

The collagen metabolism and the expression of matrix metalloproteinase during atrial fibrillation

作　　者：谭蓓[1] 张海澄[1] 曹磊[1] 高瑾[1] 刘元生[1] 李春[1] 郭继鸿[1] 

机构地区：[1]北京大学人民医院心内科,北京100044

出　　处：《中华老年医学杂志》2008年第6期428-431,共4页Chinese Journal of Geriatrics

基　　金：基金项目：国家自然科学基金（30471710）

摘　　要：目的通过酶联免疫吸附方法，对心房颤动（房颤）患者血清胶原代谢标志物I型前胶原羧基端肽（carboxy terminal propeptide of type I procollagen，PICP）、I型前胶原氨基端肽（nitrogen terminal propeptide of type Iprocollagen，PINP）、Ⅲ型前胶原氨基端肽（nitrogen terminal propeptide of type Ⅲ procollagen，PⅢ NP）、I型胶原羧端交联肽（type I collagen carboxy terminal telopeptide，ICTP）和基质金属蛋白酶（Matrix metalloproteinases，MMPs）及其内源性抑制剂金属蛋白酶组织抑制因子（tissue inhibitors of metalloproteinases，TIMPs）表达进行定量研究，以探讨房颤时心房的结构重构。方法选取71例老年患者，其中永久性房颤组24例，阵发性房颤组24例，窦性心律组23例。应用ELISA法检测患者血清中PICP、PINP、PⅢNP、ICTP及MMP-1、MMP-2、MMP-7、MMP-9、TIMP-1和TIMP-2的含量。结果永久性房颤组PICP较阵发性房颤组及窦性心律组分别升高25．4％和42．8％（P〈0．05）。永久性房颤组PⅢNP较阵发性房颤组及窦性心律组分别升高17．9％和35．6％（P〈0.05），阵发性房颤组较窦性心律组升高15．0％（P〈0．05）。3组间PINP和ICTP比较，差异无统计学意义（均为P〉0.05）。阵发性房颤组MMP-1较窦性心律组升高25．6％（P〈0.05）。永久性房颤组MMP-2较阵发性房颤组及窦性心律组分别升高54．9％和37．9％（P〈0．05）。3组间MMP-7、MMP-9及TIMP-1比较，差异无统计学意义（均为P〉0．05）。永久性房颤组及阵发性房颤组TIMP-2较窦性心律组下降21．8％和11．8％（P〈0.05）。结论房颤时，MMPs-TIMPs系统间相互作用失衡，使胶原合成与降解失衡，这可能是房颤时心房结构重构的机制之一，与房颤的发生和维持有关。Objective To quantify the expressions of collagen metabolic markers carboxy terminal propeptide of type I procollagen （PICP）, nitrogen terminal propeptide of type I procollagen （PINP）, nitrogen terminal propeptide of type Ⅲ procollagen （P Ⅲ NP） , type I collagen carboxy terminal telopeptide （ICTP）, matrix metalloproteinases （MMPs）and the tissue inhibitor of metalloproteinases （TIMPs）in the serum of atrial fibrillation patients by enzyme linked immunosorbent assay （ELISA）, and to discuss the atrial structural remodeling during atrial fibrillation （AF）. Methods 71 elderly patients were enrolled, 24 patients had permanent AF, 24 patients had paroxysmal AF, and 23 patients were in sinus rhythm. The serum levels of all markers were measured by ELISA. Results PICP was increased in permanent AF group versus the paroxysmal AF group and sinus rhythm group by 25.4% and 42.80% （all P〈0.05）, respectively. Pill NP was increased in permanent AF group versus the paroxysmal AF group and sinus rhythm group by 17.9% and 35.6%（all P〈0.05）, respeetively, and was increased in the paroxysmal AF group versus the sinus rhythm group by 15.0% （P〈0.05）. PINP and ICTP did not differ significantly between the 3 groups （all P 〉0.05）. MMP-1 was significantly increased by 25.6%（P〈0.05） in the paroxysmal AF group versus the sinus rhythm group. MMP-2 was also significantly increased in permanent AF group versusthe paroxysmal AF group and sinus rhythm group by 54.9% and 37.9%（all P〈0.05）, respectively. MMP-7, MMP-9 and TIMP-1 did not differ significantly between the 3 groups （P〉0.05）. TIMP-2 was significantly decreased in the permanent AF group and paroxysmal AF group versus the sinus rhythm group by 21.8% and 11.8%（P〈0.05）, respectively. Conclusions Disturbance in the balance of MMP/TIMP system may perturb the balance of collagen synthesis and degradation during atrial fibrillation. This may be a contributing mechanism to atrial structural remodeling in atrial fib

关 键 词：房颤 胶原 基质金属蛋白酶类 金属蛋白酶组织抑制剂 

分 类 号：R686[医药卫生—骨科学]