二尖瓣病变患者血浆赖氨酸氧化酶水平与持续性心房颤动的关系

The Relationship between Plasma Lysyl Oxidase Level and Persistent Atrial Fibrillation with Mitral Valvular Disease

目的探讨二尖瓣病变患者赖氨酸氧化酶(lysyl oxidase,LOX)表达与持续性心房颤动(atrial fibrillation,AF)的关系。方法 2012年3月至2014年2月纳入我院拟行瓣膜置换术187例二尖瓣膜病变患者。根据是否伴有持续性AF,将研究患者分为窦性心律(sinus rhythm,SR)组和AF组。在AF组,根据患者的二尖瓣病变类型,进一步分组为二尖瓣狭窄(mitral stenosis,MS)伴AF组(MS+AF组)和二尖瓣反流(mitral regurgitation,MR)伴AF组(MR+AF组)。AF组97例,男44例、女53例,年龄(52.76±11.35)岁;SR组90例,男48例、女42例,年龄(47.95±14.22)岁。结果二尖瓣病变患者中51.87%(97/187)伴有AF,与二尖瓣反流相比,二尖瓣狭窄较多伴有持续性AF(60.31%vs.34.43%,P<0.05)。AF组血浆LOX表达水平明显高于SR组(73.78±25.42IU/L vs.51.05±18.96 IU/L,P<0.05)。在AF患者中,MS组的LOX水平高于MR组(84.21±32.15 IU/L vs.59.74±35.21IU/L,P<0.05)且易伴有血栓。多元回归分析结果显示:AF与LOX水平(r=0.124,P=0.036)及左心房直径(r=0.531,P=0.042)有关。结论二尖瓣病变患者血浆LOX水平升高与AF发生有关,二尖瓣狭窄患者尤为明显。

Objective To investigate whether lysyl oxidase(LOX) has significant relation to persistent atrial fibrillation(AF) with mitral valvular diseases. Methods We included 184 consecutive lone mitral valvular disease patients who needed surgery in our hospital between March 2012 and February 2014. Patients who had persistent AF formed the AF group,and those who still kept sinus rhythm(SR) comprised the SR group. In the AF group,patients were separated into two groups by the subgroup of mitral valvular disease(mitral stenosis and mitral regurgitation),then formed a MS+AF group and a MR+AF group. There were 97 patients with 44 males and 53 females at age of 52.76±11.35 years in the AF group and 90 patients with 48 males and 42 females at age of 47.95±14.22 years in the SR group. Blood specimens were obtained from patients for the first time peripheral venous blood after admitted to hospital. LOX levels were measured by ELISA test kits of LOX. Results AF was diagnosed in 51.87%(97/187) of lone mitral valvular disease patients. Mitral stenosis patients were easy to have AF(60.31% vs. 34.43%,P<0.05). The plasma level of LOX was significantly higher in the AF group than that in the SR group(73.78±25.42 IU/L vs. 51.05±18.96 IU/L,P<0.05). In the AF group,the LOX level in the mitral stenosis group was higher than that in the mitral regurgitation group(84.21±32.15 IU/L vs. 59.74±35.21 IU/L,P<0.05). Mitral stenosis patients more frequently had a history of stroke than mitral regurgitation patients did. AF correlated significantly with the level of LOX(r=0.124,P=0.036) and left atrial dimension(r=0.531,P=0.042). Conclusions We validate and extend the hypothesis that increasing LOX level predicts an increasing risk of AF in mitral valvular diseases. Lysine oxidase is a potential diagnostic biomarker for AF. It is expressed significantly in mitral stenosis patients with AF especially.