慢性心房颤动患者血清醛固酮水平与胶原合成血清学标志相关  

Serum aldosterone correlates positively with circulating markers of collagen synthesis in chronic atrial fibrillation patients.

作　　者：王晓虎[1] 林皓平[1] 黄明方[2] 盖晓波[2] 兰小鹏[2] 占凌[1] 

机构地区：[1]福建省心血管病研究所心内科,福建福州350001 [2]南京军区福州总医院心血管内科全军医学检验中心检验科

出　　处：《中国心脏起搏与心电生理杂志》2009年第5期410-412,共3页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：目的探讨慢性心房颤动(简称房颤)患者血清醛固酮水平与胶原合成的血清学标志之间的相关性。方法收集72例慢性房颤患者(房颤组)及50例窦性心律患者(对照组)。用放射免疫法测定血清醛固酮水平,用酶联免疫吸附分析法测定血清Ⅰ型胶原羧基端前肽(Ⅰ型CP)及Ⅲ型胶原前多肽(Ⅲ型NP)的水平。结果房颤组血清Ⅰ型CP水平显著高于对照组(P<0.01),伴左房扩大的房颤患者Ⅰ型CP水平更高(P<0.01),并且血清Ⅰ型CP水平与左房内径呈正相关。两组受试者中血清Ⅲ型NP水平无显著差别。与对照组相比,房颤组血清醛固酮水平显著增高(P<0.01),伴左房扩大的房颤患者醛固酮水平更高。血清醛固酮水平与左房内径及血清Ⅰ型CP水平呈正相关。结论慢性房颤患者血清醛固酮升高,并与血清Ⅰ型CP水平呈正相关,提示过高的醛固酮水平可能参与心房纤维化形成及房颤的维持。Objective To investigate whether serum aldosterone level and the serum markers of collagen synthesis is correlated in patients with chronic atrial fibrillation （CAF） and in sinus rhythm （SR） subjects. Methods Serum concentrations of aldosterone, carboxy-terminal peptide of procollagen type I （PICP） and amino-terminal propeptide of proeollagen type Ⅲ（PⅢNP） , indexes of collagen type I and type m synthesis were respectively measured in 72 CAF patients and in 50 control subjects with SR. Results Serum aldosterone levels were significantly higher in patients with CAF than those in the control subjects （398.1 ±84.3 pg/ml vs 265.4±66.7 pg/ml, P 〈 0.01 ）. Serum PICP levels, but not serum PⅢNP levels, were significantly higher in patients with CAF compared with the control subjects （165.7± 30.7μg/L vs 108.3±22.8μg/L, P 〈0. 01 ）. This finding was more evident in CAF patients with larger left atrial size, in whom aldosterone and PICP （446.6 ±97.4 pg/ml and 181.6 ± 31.2 μg/L, respectively） were greater than those in CAF patients with normal left size （332.7±76.9 pg/ml, P 〈0.01 and 145.1±25.3 μg/L, P 〈0.05, respectively）. In addition, there was a positive correlation between aldosterone levels and PICP levels in patients with CAF （ r = 0.37, P 〈 0.01 ）. Conclusions Serum aldosterone levels differed significantly between patients with CAF and SR, and correlated with serum marker of collagen type I synthesis in CAF patients, suggesting aldosterone excess may be responsible for arrhythmogenic atrial fibrosis and AF maintenance. [ Chinese Journal of Cardiac Pacing and Electrophysiology,2009,23 （5） ：410 -412]

关 键 词：心血管病学 心房颤动 胶原 醛固酮 纤维化 

分 类 号：R541.75[医药卫生—心血管疾病]