中介素与高血压合并房颤患者心房纤维化的关系

Relationship Between Intermedin and Atrial Fibrosis in Patients of Hypertension Combined with Atrial Fibrillation

观察中介素（IMD）在高血压合并房颤患者的变化及与心房纤维化的关系。从2010年6月~2011年6月在四川大学华西医院心内科门诊随访的患者中,筛选出符合要求的受试者150例参加研究。其中包括单纯高血压组（50例）,高血压合并阵发性房颤组（48例）,高血压合并持续性房颤组（52例）。对受试者完善病史收集及体格检查,进行心脏彩超检查,酶联免疫吸附法测定血浆IMD和转化生长因子β-1（TGF-β1）水平。试验结果显示：1血浆IMD、TGF-β1、左房直径（LAD）水平在三组间比较,差异有统计学意义且分布趋势一致,均是高血压合并房颤组高于单纯高血压组,且持续性房颤组高于阵发性房颤组。2相关性研究结果显示IMD与TGF-β1呈正相关（r=0.51,P〈0.001）,IMD与LAD呈正相关（r=0.59,P〈0.001）,TGF-β1与LAD呈正相关（r=0.57,P〈0.001）;偏回归分析显示IMD与TGF-β1呈正相关（标准系数β=0.31,P〈0.001）,IMD与LAD呈正相关（标准系数β=0.40,P〈0.001）,TGF-β1与LAD呈正相关（标准系数β=0.31,P〈0.001）。结果提示,随房颤进展心房结构纤维化逐渐加重,IMD可能抑制了心房肌纤维化的病理生理过程。

This study was aimed to evaluate the relationship between the changes of plasma intermedin（IMD）and atrial fibrosis in hypertensive patients with atrial fibrillation.During the period from 2010 to 2011,appropriate 150 subjects of out-patients（female 50%,male 50%）were selected in West China Hospital,Sichuan University,and were divided into three groups：the hypertension-only group,the hypertension combined with paroxysmal atrial fibrillation group and the hypertension combined with persistent atrial fibrillation group.Firstly,we collected the Physical examination results and medical history records of the patients.We then performed ultrasound cardiogram and blood biochemical tests on the patients.We also detected the plasma IMD and transforming growth factorβ1（TGF-β1）using ELISA.The results showed that compared with the hypertensive group,the plasma level of IMD,TGF-β1and left atrium director（LAD）in the hypertensive combined with atrial fibrillation group were higher significantly.Compared with the paroxymal atrial fibrillation group,the levels of IMD,TGF-β1and LAD were higher significantly in persistent atrial fibrillation group.Analysis of correlation and partial correlation showed that IMD was positively correlated with TGF-β1（r=0.51,P〈0.001）,IMD was positively correlated with LAD（r=0.59,P〈0.001）,and TGF-β1was positively correlated with LAD（r=0.57,P〈0.001）.The results suggest that IMD might suppress the pathophysiological process of atrial fibrillation.