室上速射频消融后基质金属蛋白酶9增高未能动员单个核细胞

Increased MMP-9 levels is not associated with mononuclear cells mobilization in paroxysmal supraventricular tachycardia patients undergoing radiofrequency catheter ablation

目的探讨阵发性室上性心动过速(PSVT)患者射频消融后有无干细胞动员及机制。方法连续收集实施射频消融的 PSVT 患者 20 例。采集射频消融前及其后第 1 天的外周血,使用流式细胞仪检测 CD117+ 单个核细胞、CXCR4+ 单个核细胞、CD133+ CD34+ 单个核细胞比例,采用酶联免疫法(ELISA)检测基质金属蛋白酶-9(MMP-9)、人生长调节致癌基因β/黑素瘤生长刺激因子(GR0β)、基质细胞衍生因子 1(SDF-1)、白细胞介素 6(IL-6)、白细胞介素 8(IL-8) 、粒细胞集落刺激因子(G-CSF)、血管紧张素 1(ANG1)、cTnT及 CK-MB 等。结果 PSVT 患者射频消融后 cTnT 及 CK-MB 显著增高(0.01 ± 0.047 ng/ml vs 0.195 ± 0.038 ng/ml,P<0.001 ;12.5 ± 3.75 u/l vs 15.40 ± 1.03 u/l, P=0.016)。MMP-9 术后较术前明显增高(23.265±3.922 ng/ml vs 35.082 ± 5.435 ng /ml, P<0.001),其余细胞因子均无明显变化。cTnT(R=0.544,P=0.013)及 CK-MB(R=0.519,P=0.019) 与 CD133+ CD34+ 单个核细胞比例呈正相关,但外周血无 CD117+单个核细胞、CXCR4+ 单个核细胞、CD133+ CD34+ 单个核细胞动员。结论 PSVT 患者射频消融导致心肌损伤及 MMP-9 显著增高 , 但损伤程度尚不足以动员 CD117+ 单个核细胞、CXCR4 + 单个核细胞、CD133+ CD34+ 单个核细胞。

Objective To investigate mononuclear cells mobilization mediated by myocardial injury after RFCA in patients with PSVT.Methods Blood samples were collected in 20 in-patients with PSVT on admission and the day after RFCA.Matrix metalloproteinase(MMP)-9,human growth regulator oncogene β /melanoma growth-stimulating factor(GROβ),stromal cell-derived factor(SDF)-1,interleukin(IL)-6,IL-8,granulocyte colony-stimulating factor(G-CSF),angiotensin(ANG)1,cardiac troponin T(cTnT) and creatine kinase-MB(CK-MB) were measured by ELISA.CD117+,CXCR4+ and CD133+ CD34+ mononuclear cells were analyzed by flow cytometry.Results A rise in creatine kinase-MB(CK-MB)and cardiac troponin T(cTnT) levels indicated myocardial necrosis in PSVT patients undergoing RFCA(0.01 ± 0.047 ng/ml vs 0.195 ± 0.038 ng /ml,P<0.001;12.5 ± 3.75 u/l vs 15.40 ± 1.03 u/l,P=0.016).MMP-9 levels increased significantly after the procedure(P<0.001),neither did SDF-1,GROβ,IL-6,IL-8,G-CSF or ANG1 levels.CTnT(R=0.54,P=0.013) and CK-MB(R=0.519,P=0.019) levels were positively correlated with the proportion of CD133+ CD34+ mononuclear cells.Yet,no significant changes were observed in the proportion of circulating CD117 +,CXCR4+ or CD133 + CD34+ mononuclear cells.Conclusion Although RFCA in PSVT patients induced myocardial injury and an increase in MMP-9 levels,the degree of injury is still not enough to mobilize mononuclear cells.