持续性心房颤动患者血清MMP-9水平变化及其对射频消融术后房颤复发的预测效能  

Changes of serum MMP-9 levels in patients with persistent atrial fibrillation and its predictive efficacy for the recurrence of atrial fibrillation after radiofrequency ablation

作　　者：邢布点 魏婷 卢园园 冷俊杰 康品方[1] 张宁汝[1] XING Budian;WEI Ting;LU Yuanyuan;LENG Junjie;KANG Pinfang;ZHANG Ningru(Cardiovascular Department,The First Affiliated Hospital of Bengbu Medical College,Bengbu 233000,China;不详)

机构地区：[1]蚌埠医学院第一附属医院心血管科,安徽蚌埠233000 [2]蚌埠医学院第一附属医院心脑血管疾病基础与临床重点实验室 [3]蚌埠医学院附属蚌埠第三人民医院

出　　处：《山东医药》2022年第33期5-8,共4页Shandong Medical Journal

基　　金：国家自然科学基金资助项目(81970313);安徽省重点研究和开发计划(1804h08020246)。

摘　　要：目的观察持续性心房颤动(AF)患者血清基质金属蛋白酶-9(MMP-9)水平变化,分析其对持续性AF患者射频消融术后复发的预测效能。方法AF患者154例,包括阵发性AF患者54例(阵发性组)、持续性AF患者60例(持续性组)、永久性AF患者40例(永久性组)。选取健康体检者110例记为对照组。60例持续性AF患者采用射频消融术治疗消除房颤,术后随访,依据是否发生AF复发分为复发组11例、未复发组49例。采用ELISA法检测各组血清MMP-9、金属蛋白酶组织抑制剂-1(TIMP-1)。以单因素分析中差异有统计学意义的指标为自变量,采用二元Logistic回归分析法分析持续性AF患者射频消融术后复发的影响因素。采用受试者工作特征曲线(ROC)分析血清MMP-9对持续性AF患者射频消融术后复发的预测效能。结果阵发性组、持续性组、永久性组、对照组血清MMP-9、TIMP-1表达水平组间相比,P均<0.05。复发组患者血清MMP-9表达水平显著高于未复发组(P<0.05)。血清MMP-9(OR=1.140,95%CI:1.053~1.708,P<0.05)是持续性AF患者射频消融术后复发的独立影响因素。血清MMP-9水平预测持续性AF患者射频消融术后复发的AUC为0.779(P<0.01),取截断值为14.30 ng/mL时,血清MMP-9水平预测持续性AF患者射频消融术后复发的灵敏度为66.8%、特异度为81.9%。结论不同类型AF患者血清MMP-9、TIMP-1表达水平存在差异;射频消融术后复发的持续性AF患者血清MMP-9表达水平升高,血清MMP-9是持续性AF患者射频消融术后复发的独立影响因素,检测血清MMP-9可用于持续性AF患者射频消融术后复发的预测。Objective To observe the changes of serum matrix metalloproteinase-9(MMP-9)levels in patients with persistent atrial fibrillation(AF),and to analyze its predictive efficacy for recurrence after radiofrequency ablation in patients with persistent AF.Methods There were 154 patients with AF,including 54 patients with paroxysmal AF(paroxysmal group),60 patients with persistent AF(persistent group)and 40 patients with permanent AF(permanent group).A total of 110 healthy subjects were selected as the control group.Sixty patients with persistent AF were treated with radiofrequency ablation to eliminate atrial fibrillation.According to the postoperative follow-up,they were divided into the recurrence group(11 cases)and non-recurrence group(49 cases).Serum MMP-9 and metalloproteinase tissue inhibitor-1(TIMP-1)were detected by ELISA.The indicators with statistically significant differences in univariate analysis were used as independent variables,and the influencing factors of recurrence in patients with persistent AF after radiofrequency ablation were analyzed by binary Logistic regression analysis.The predictive efficacy of serum MMP-9 for recurrence in patients with persistent AF after radiofrequency ablation was analyzed by receiver operating characteristic curve(ROC).Results Significant differences were found in the expression levels of serum MMP-9 and TIMP-1 between the paroxysmal group,persistent group,permanent group and control group(all P<0.05).The serum MMP-9 expression level in the recurrence group was significantly higher than that in the non-recurrence group(P<0.05).Serum MMP-9(OR=1.140,95%CI:1.053–1.708,P<0.05)was an independent factor for recurrence in patients with persistent AF after radiofrequency ablation.The AUC of serum MMP-9 in patients with persistent AF after radiofrequency ablation was 0.779(P<0.01).When the cut-off value was 14.30 ng/mL,the sensitivity and specificity of serum MMP-9 in patients with persistent AF after radiofrequency ablation were 66.8%and 81.9%,respectively.Conclusions The exp

关 键 词：心房颤动 持续性心房颤动 基质金属蛋白酶-9 金属蛋白酶组织抑制剂-1 射频消融术 

分 类 号：R541.75[医药卫生—心血管疾病]