基质金属蛋白酶-2及其组织抑制因子与心房颤动的相关性研究

Research on the Correlation between Atrial Fibrillation and the Matrix Metalloproteinase-2 and its Tissue Inhibitors

目的探讨血清基质金属蛋白酶-2(MMP-2)及其组织抑制因子(TIMP-2)水平变化与心房颤动的关系。方法采用酶联免疫吸附法(ELISA法)测定48例心房颤动患者(心房颤动组)血清MMP-2水平和TIMP-2水平,记录心功能分级(NYHA),超声心动图检测左室舒张末内径(LVEDD)。选取45例窦性心律患者(窦性心律组)作对照研究。结果(1)心房颤动组血清MMP-2水平为(109.73±48.05)ng/ml,显著高于窦性心律组的(62.38±20.47)ng/ml,差异有统计学意义(P<0.01);血清TIMP-2水平为(123.54±22.19)ng/ml,低于窦性心律组的(138.65±41.48)ng/ml,差异有统计学意义(P<0.01)。(2)心房颤动组血清MMP-2水平与NYHA和LVEDD均呈正相关,而与TIMP-2水平呈负相关(分别为r=0.418,P=0.003;r=0.386,P=0.007;r=-0.329,P=0.034);TIMP-2水平与NYHA和LVEDD均无直线相关(分别为r=-0.176,P=0.317;r=-0.148,P=0.443)。(3)窦性心律患者血清MMP-2水平与NYHA呈正相关(r=0.379,P=0.010),而与TIMP-2水平呈负相关(r=-0.317,P=0.042);血清MMP-2水平和TIMP-2水平与LVEDD均无直线相关(分别为r=0.241,P=0.111和r=-0.209,P=0.186)。结论心房颤动患者血清MMP-2水平升高和TIMP-2水平下降可能是心房纤维化发生的分子机制之一,与心房颤动的发生和维持有关。

Objective To investigate the relationship between atrial fibrillation （AF） and the serum levels of matrix metalloproteinase-2 （MMP-2） and its tissue inhibitors （TIMP-2）. Methods The serum levels of MMP-2 and TIMP-2 in 48 patients with AF were measured by ELISA,and LVEDD was measured by echocardiography,meanwhile the NYHA classification was recorded. 45 patients with sinus rhythm were selected as the control group. Results （1） The serum level of MMP-2 in patients with AF was significantly higher than that of control group （P 〈0. 01 ） ,the serum level of TIMP-2 in patients with AF was significantly lower than that of control group （P 〈0. 01 ）. （2） In patients with AF,there was a positive correlation between the serum levels of MMP-2 and the NYHA classification （r = 0. 418, P =0.003） and LVEDD （r = 0.386,P = 0. 007）, and a negative correlation with the serum level of TIMP （ r = - 0. 329, P = 0. 034）. There was no linear correlation between TIMP and LVEDD and the NYH classification. （3） In patients with sinus rhythm,there was a positive correlation between the serum levels of MMP-2 and the NYHA classification （r =0. 379,P =0. 0103）, and a negative correlation between the serum levels of TIMP and the NYHA classification （r = -0. 317,P =0.0417）. There was no linear correlation between MMP-2,TIMP-2 and LVEDD （r =0.241 ,P =0.111 and r = - 0. 209, P = 0. 186 respectively）. Conclusion The increase of MMP-2 and the decrease of TIMP-2 might be one of the molecular mechanisms of AF,which correlated with the initiation and maintenance of AF.