MMP-9和HIF-1α水平变化在预测房颤射频消融术后复发的临床价值  

Correlation between MMP-9 and HIF-1α level change and recurrence of atrial fibrillation in patients underwent catheter ablation

作　　者：裴晓冬[1] 葛华[1] 刘丽楠 裴俊丰 刘永[1] 赵雅琳[1] 

机构地区：[1]沈阳医学院附属中心医院,沈阳110024

出　　处：《慢性病学杂志》2015年第5期515-518,共4页Chronic Pathematology Journal

摘　　要：目的研究基质金属蛋白酶-9(MMP-9)及缺氧诱导因子-1α(HIF-1α)在心房颤动患者血清中的表达及其与导管消融术复发率的相关性。方法回顾性分析95例房颤患者,其中阵发性房颤55例,持续性房颤40例,均行导管消融术治疗。术后3个月随访,进一步分为复发组和成功组。相关检查包括术前、术后3个月两个时间点MMP-9和HIF-1α水平,并同时行超声心动图等临床检查。比较复发组与成功组间MMP-9和HIF-1α水平差异及其与复发的相关性。结果 3个月随访结果,导管消融术后总体复发率为27.4%(26/95),持续性房颤患者复发率40.0%(16/40)明显高于阵发性房颤者18.2%(10/55)。复发组患者术前血清MMP-9和HIF-1α水平[(664.87±267.16)ng/L和(79.52±27.08)ng/L]较成功组[(515.65±246.53)ng/L和(62.74±20.37)ng/L]明显增高,差异有统计学意义(P<0.05)。持续房颤组和阵发性房颤组内,复发病例的术前血清MMP-9和HIF-1α水平均高于成功病例。导管消融术3个月时,成功组MMP-9和HIF-1α水平较术前显著降低(变化量ΔMMP-9、ΔHIF-1α分别为87.84±50.16和21.87±5.58,P<0.01),而复发组无明显变化(P=0.539)。多因素logistic回归分析结果显示术前MMP-9和HIF-1α水平,术前术后ΔMMP-9、ΔHIF-1α与房颤导管消融术后复发相关。结论术前MMP-9、HIF-1α水平以及手术前后ΔMMP-9、ΔHIF-1α与房颤导管消融术后复发相关。Objective To investigate the expression level of matrix metalloproteinase 9(MMP-9) and hypoxia inducible factor 1 alpha(HIF-1α) in patients with atrial fibrillation(AF) before and after catheter ablation. To study the correlation between level of MMP- 9 and HIF-1α and recurrence of AF.Methods A retrospective analysis of 95 AF patients including 55 paroxysmal AF and 40 persistent AF, all receiving catheter ablation, was conducted. All patients were followed up for 3 months, and then divided into the success and the recurrence group according to the postoperative recurrence. Serum MMP-9 and HIF-1α levels were measured at two time points including preoperation and 3 months after operation. Echocardiography and other clinical examinations were carried out for all patients at the same time. Results After 3 months of follow-up, the total AF recurrence rate was 27.4%(26/95).The recurrence rate of persistent AF(40.0%) was dramatically higher than that of paroxysmal AF(18.2%). Preoperative MMP- 9 and HIF- 1α levels of recurrence group(664.87 ± 267.16 ng/L and79.52± 27.08 ng/L, respectively) were remarkably higher than those of success group(515.65 ± 246.53ng/L and 62.74±20.37 ng/L, respectively), with statistically significant difference(P<0.05). Preoperative MMP-9 and HIF-1α levels of the recurrence group were higher than those of the success group for both persistent AF and paroxysmal AF cases. Compared with the preoperation, levels, MMP- 9 and HIF-1α levels were significantly decreased(changes of MMP at 87.84±50.16 and changes of HIF-1α at21.87 ± 5.58, P<0.01) at 3 months follow- up end for the success group, but not for the recurrence group. Logistic regression analysis showed that high level of preoperative MMP- 9 and HIF- 1α and more dramatic changes of MMP-9 and HIF-1α levels were significantly related to AF recurrence. Conclusions Preoperative MMP-9 and HIF-1α level, and changes of MMP-9 and HIF-1α levels before and after operation are closely related to recurrence of AF after catheter ablation.

关 键 词：心房颤动 导管消融术 复发 基质金属蛋白酶-9 缺氧诱导因子-1Α 

分 类 号：R541.75[医药卫生—心血管疾病]