【摘要】 目的研究心房颤动患者心房组织基质金属蛋白酶-1和基质金属蛋白酶-9(MMP-1,MMP-9)及其组织型基质金属蛋白酶抑制因子-1(TIMP-1)的基因表达,并探讨其与心房结构重构的关系。方法将28例风湿性心脏病接受换瓣手术患者的右心耳标本分为3组,窦性心律组8例,阵发性房颤组8例,持续性房颤组12例,采用半定量逆转录-聚合酶链反应(RT-PCR)技术检测心房组织中MMP-1、MMP-9和TIMP-1基因表达。结果(1)与窦性心律组比较,阵发性房颤组MMP-1的mRNA表达虽有增加,但无显著性差异,而持续性房颤组MMP-1的mRNA表达显著增加(P<0.05);(2)MMP-9的mRNA表达在窦性心律组、阵发性房颤组和持续性房颤组心房组织的表达逐渐增加(P<0.05)。MMP-9的mRNA水平与房颤持续的时间、左心房的内径成显著的正相关(r=0.509,0.543,P<0.01);(3)与窦性心律组比较,阵发性房颤组和持续性房颤组TIMP-1的mR-NA水平明显下降(P<0.05,P<0.01)。TIMP-1的mRNA水平与房颤持续的时间、左心房的内径成显著的负相关(r=-0.43,-0.387,P<0.05)。结论房颤患者的MMP-1、MMP-9和TIMP-1相互间的作用失衡可能与慢性房颤时的心房结构重构有关。更多还原

【Abstract】 Objective To determine the relationship between matrix metalloproteinase-1(MMP-1),MMP-9,tissue inhibitors of metalloproteinases(TIMP)-1 and the atrial structural remodeling during atrial fibrillation(AF).Methods The right atrial tissue samples were obtained from 8 patients without a history of AF,8 patients with paroxysmal AF and 12 patients with persistent AF undergoing heart valve replacement surgery for rheumatic heart diseases.mRNA levels of MMP-1,MMP-9 and TIMP-1 were measured by semi-quantitative reverse transcription polymerase chain reaction(RT-PCR).Results(1)The mRNA level of MMP-1 was increased in the paroxysmal AF group in comparison to the sinus rhythm group but no statistics difference.It increased significantly in the persistent AF group(P<0.05) compared with the sinus rhythm.(2)In the sinus rhythm group,paroxysmal AF group and persistent AF group,the mRNA level of MMP-9 was significantly increased in turn(P<0.05) in the three groups.The expression of MMP-9 mRNA was positively correlated with AF duration and the left atrial diameter(r=0.509,0.543,P<0.01).(3)TIMP-1 expression at mRNA level was down-regulated in the paroxysmal AF and persistent AF groups(P<0.05,P<0.01).The expression of TIMP-1 mRNA was negatively correlated with AF duration and the left atrial diameter(r=-0.43,-0.387,P<0.05).Conclusion The up-regulation of MMP-1,MMP-9 mRNA level,along with the down-regulation of TIMP-1 mRNA level may contributed to the atrial structural remodeling.更多还原