心房颤动患者血清热休克蛋白27水平与导管消融效果的相关性  

The expression of heat shock protein 27 in patients with atrial fibrillation and its correlation with catheter ablation outcomes

作　　者：张力[1] 江洪[1] 鲁志兵[1] 何文博[1] 陈静[1] 余锂镭[1] 周文杰[1] 余小梅[1] 

机构地区：[1]武汉大学人民医院心内科,武汉430060

出　　处：《临床心血管病杂志》2014年第12期1077-1080,共4页Journal of Clinical Cardiology

基　　金：国家自然科学基金资助项目(No:81100128;81070143;81270250);中央高校基本科研业务费专项资金;武汉大学自主科研项目(No:4101024;302274020);教育部博士点专项基金新教师基金(No:20100141120072);武汉市青年科技晨光计划(No:201271031429)

摘　　要：目的：研究热休克蛋白27（HSP27）在心房颤动（房颤）患者血清中的表达及其与射频消融术成功率的关系。方法：纳入60例患者,其中30例行环肺静脉电隔离术的房颤患者为房颤组,另30例行射频消融术的阵发性室上性心动过速（PSVT）患者为对照组。所有患者均于术前采集静脉血,用ELISA法测定血清HSP27水平。房颤组于术后3个月随访,并复查血清HSP27水平。比较各组的血清HSP27水平差异及其与房颤术后复发的相关性。结果：房颤组患者血清HSP27水平显著高于对照组（P=0.028）。房颤组术后3个月复查时,9例有房颤复发（复发组）,21例维持窦律（窦律组）;窦律组术前血清HSP27水平较复发组无显著差异（P=0.757）,而术后血清HSP27水平显著高于复发组（P〈0.001）。消融术后3个月时,窦律组血清HSP27水平较术前有显著性升高（P〈0.001）,而复发组无显著升高（P=0.505）。与消融术后房颤复发显著相关的变量为：老龄（P=0.025）、左心房直径（P=0.04）、高血压（P=0.048）、术后HSP27血清水平（P〈0.001）及△HSP27（术后3个月HSP27变化量,P=0.044）,其中老龄（OR=6.4,95%CI：1.156～35.437,P=0.034）、术后HSP27血清水平（OR=0.964,95%CI：0.939～0.990,P=0.006）及左心房直径（OR=1.259,95%CI：1.047～1.515,P=0.015）是复发的独立预测因素。结论：消融术后血清HSP27水平显著升高的患者复发风险较小。术后定期复查血清HSP27水平可能有助于评估消融术后的复发风险。Objective：To study the expression of heat shock protein 27 （HSP27） in patients with atrial fibrilla- tion （AF） and its correlation with the outcome of radiofrequency catheter ablation. Method：A total of 60 patients was enrolled in the study, including 30 AF patients undergoing circumferential pulmonary vein isolation as AF group and 30 patients with paroxysmal supraventricular tachycardia receiving radiofrequency ablation as control group. Blood samples were collected before ablation and serum levels of HSP27 were measured with ELISA meth- od. Patients in AF group were followed-up 3 months after ablation and HSP27 levels were reexamined. HSP27 levels of different groups were compared and the correlation between HSP27 levels and the recurrence of AF after ablation were analyzed using correlation analysis. Result： During follow-up, 9 patients in AF group had early re- currence in 3 months after ablation, while the remaining 21 patients had no recurrence. Serum HSP27 levels of AF group were significantly higher compared with control group （P=0. 028）. Before ablation, there was no signifi- cant difference in serum HSP27 levels was found between patients with and without AF recurrence （P= 0. 757）. However, after ablation, serum HSP27 levels in patients without recurrence were significantly higher compared with those with recurrence. A significant elevation in serum HSP27 levels were observed in patients without recurrence 3 months after ablation （P=0. 001）, while serum HSP27 levels in patients with recurrence remained un- changed （P=0. 505） . In addition, old age （P = 0. 025）, left atrial diameter （P = 0.04）, hypertension （P=0. 048）, serum HSP27 levels after ablation（P〈0. 001） and AHSP27（P=0. 044） were significantly related to AF recurrence after ablation. Old age（OR=6.4,95% 1. 156～35. 437,P=0. 034）, serum HSP27 levels after ab- lation （OR=0.964,95%CI： 0.939--0.990,P=0.006） and left atrial diameter （0R=1.259,95%CI： 1.047% 1. 515 ,P=0. 015） were inde

关 键 词：心房颤动 射频消融术 热休克蛋白27 

分 类 号：R541.7[医药卫生—心血管疾病]