低氧诱导因子1α与心房颤动发生和维持的关系

Relationship of hypoxia-inducible factor-1α with occurrence and maintenance of atrial fibrillation

目的探讨低氧诱导因子1α(HIF-1α)与心房颤动发生和维持的关系。方法入选125例临床资料完整的心房颤动患者,其中阵发性心房颤动34例,持续性心房颤动49例,永久性心房颤动42例,窦性心律者38例作为对照组。比较各组患者血清中HIF-1α的表达水平,同时测量左心房内径。结果永久心房颤动组左心房内径较持续心房颤动组(44.65±6.67)mm vs(41.15±5.53)mm(P<0.05),阵发心房颤动组(44.65±6.67)mm vs(38.62±4.63)mm(P<0.05)及对照组(44.65±6.67)mm vs(38.03±3.80)mm显著增加(P<0.05),持续心房颤动组左心房内径较阵发心房颤动组(41.15±5.53)mm vs(38.62±4.63)mm,对照组(41.15±5.53)mm vs(38.03±3.80)mm显著增加(P<0.05),阵发心房颤动组与对照组比较差异无统计学意义(P>0.05)。HIF-1α表达水平在永久心房颤动组明显高于阵发心房颤动组及对照组(83.12±26.39)ng/L vs(67.15±31.91)ng/L vs(55.97±18.01)ng/L(P<0.05);持续心房颤动组高于及对照组(75.02±34.89)ng/L vs(55.97±18.01)ng/L(P<0.05);持续心房颤动组与永久心房颤动组比较差异无统计学意义(P>0.05);阵发心房颤动组与对照组比较差异无统计学意义(P>0.05)。结论 HIF-1α作为免疫炎症因子参与心房颤动的发生及维持。

Objective To study the relationship of hypoxia-inducible factor-1α（HIF-1α） as immunological and inflammatory factor with the occurrence and maintenance of atrial fibrillation. Methods 125 cases of atrial fibrillation were enrolled,34 cases were paroxysmal atrial fibrillation and 49 cases were persistent atrial fibrillation and 42 cases were permanent atrial fibrillation, besides, 38 sinus rhythm cases were also selected into the control group. HIF-1α levels of different groups were compared and left atrial diameters were measured, respectively. Results Compared with permanent atrial fibrillation group and control group, the left atrial diameter of persistent atrial fibrillation group increased,（44.65±6.67） mm vs （41.15±5.53） mm vs （38.62±4,63） mm vs （38.03±3.80） mm（P 〈0.05） respectively. The HIF-1α level of permanent atrial fibrillation group was significantly higher than that of the paroxysmal atrial fibrillation and control group（83.12±26.39） ng/L vs （67.15±31.91） ng/L,（55.97±18.01） ng/L （ P G0.05） ;The level of persistent atrial fibrillation group was significantly higher than that of control group（75.02±34.89） ng/L vs （55.97±18.01） ng/L（ P 〈0.05）, HIF-1α levels between permanent atrial fibrillation group and persistent atrial fibrillation group showed no significant difference（ P 〈0.05）, HIF-1α levels between paroxysmal atrial fibrillation and control group showed no significant difference（ P 〈0.05）. Conclusion The increase of HIF-1α level probably participates in the occurrence of atrial fibrillation, which indicates that the inflammatory reaction may promote the occurrence and maintenance of atrial fibrillation.