房颤患者血清PⅠCP和TGF-β1水平可作为评估心房结构重构的敏感血液学指标  

The levels of PICP and TGF-β1 can be regarded as serum markers for estimating atrial structural remodeling in patients with atrial fibrillation

作　　者：赵飞[1] 褚鹏[1] 王思博[1] 王伟[1] 

机构地区：[1]南京医科大学第一附属医院胸外科,江苏南京210029

出　　处：《南京医科大学学报（自然科学版）》2015年第11期1572-1579,共8页Journal of Nanjing Medical University(Natural Sciences)

摘　　要：目的:了解心房重构与纤维蛋白血清标记物的相关性,从而筛选出能够反映心房重构的敏感血液标志物。方法 :收集90例瓣膜置换手术患者的左右心房标本。患者被分为窦性节律(n=30)、阵发性房颤(n=30)和持续性房颤(n=30)3组,检测心房组织中钙-整合素结合蛋白(calcium and integrin binding protein,CIB1)、钙调神经磷酸酶A(calcineurin A)、钙调神经磷酸酶B(calcineurin B)、核内活化T细胞核因子3(nuclear factor of activated T3,NF-AT3)、核内活化T细胞核因子4(nuclear factor of activated T4,NF-AT4)、Ⅰ型纤维蛋白、Ⅲ型纤维蛋白表达情况。同时使用ELISA法检测了血清中的Ⅰ型前纤维羧基端肽(carboxy-terminal peptide of procollagen typeⅠ,PICP)、Ⅲ型前纤维氨基端前肽和Ⅰ型前纤维氨基端前肽以及TGF-β1的水平。另取10例窦性心律先天性心脏病手术患者作为对照。结果:房颤组的CIB1、calcineurin A、calcineurin B、核内NF-AT3、核内NFAT4、Ⅰ型纤维蛋白、Ⅲ型纤维蛋白的表达明显增高,特别是左心房中。持续性房颤组calcineurin系统各蛋白的表达明显高于窦性心律组。房颤患者核内NF-AT3、核内NF-AT4的表达水平与心房中的Ⅰ、Ⅲ型纤维蛋白水平明显相关。血液中的PICP和TGF-β1的水平可作为反映心房重构的重要指标。结论:calcineurin系统参与了心房的结构重构特别是纤维化的过程,PICP和TGF-β1可作为评估房颤过程中心房重构的敏感血清生物标志物。Objective： Atri al fibrillation（AF） is the most common cardiac arrhythmia in clinical practice. Unfortunately, the sensitive serum biomarkers of atrial remodeling in AF remain unclear. The aim of this study was to determine sensitive serum markers for estimating atrial structural remodeling of AF. Methods： Right and left atrial specimens were obtained from 90 patients undergoing valve replacement surgery. The patients were divided into the sinus rhythm（n = 30）,the paroxysmal atrial fibrillation（n = 30）,and the persistent atrial fibrillation（n = 30） groups. CIB1, calcineurin A, calcineurin B,nuclear factor of activated T3（NF-AT3）,nuclear factor of activated T4（NF-AT4）, collagen Ⅰ and Ⅲ protein expression in atria were measured. We also tested the levels of the carboxyl-terminal peptide of pro-collagen Ⅰ（PICP）,the N-terminal type Ⅰ procollagen propeptides, the N-terminal type Ⅲ procollagen propeptides, and TGF-β1 in serum using an enzyme immunosorbent assay. Results： Key protein expression in calcineurin system was increased in the AF groups,especially in the left atrium. In patients with AF, the expression levels of nuclear NF-AT3 and NF-AT4 were correlated with those of collagens Ⅰ and Ⅲ in the atria and with PICP and TGF-β1 in blood. Conclusion：These data support the hypothesis that PICP and TGF-β1 levels may be sensitive serum biomarkers to estimate atrial structural remodeling with at AF.

关 键 词：房颤 心房纤维化 calcineurin系统 PICP TGF-Β1 

分 类 号：R541.75[医药卫生—心血管疾病]