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本文旨在研究慢性房颤患者左右心房胶原、基质金属蛋白酶(matrix metalloproteinases,MMPs)、基质金属蛋白酶抑制剂(tissue inhibitors of metalloproteinases,TIMPs)的mRNA水平是否存在差异。选择接受开胸换心脏瓣膜的手术病人共45例,其中慢性房颤患者27例,窦性心律患者18例;术中分别取左、右心耳组织,采用半定量RT-PCR法测定I型胶原、III型胶原、基质金属蛋白酶-1,9(MMP1、MMP9)以及基质金属蛋白酶抑制剂-1(TMP1)的mRNA表达水平。结果显示:(1)与窦性心律组相比,慢性房颤组患者左、右心房肌组织中I型胶原、MMP1、MMP9的mRNA表达水平均上调(P<0.05),TMP1的表达水平均下调(P<0.01);(2)窦性心律组患者左、右心房肌组之间I型胶原、III型胶原、MMP1、MMP9、TMP1的mRNA表达水平的差异均无统计学显著意义(P>0.05);(3)慢性房颤组患者MMP1的mRNA在右心房肌组织中表达水平较左心房高(P<0.05),MMP9的mRNA在左心房肌组织中表达水平较右心房高(P<0.01);(4)无论左心房还是右心房,MMP1、MMP9的mRNA表达水平均与I型胶原的mRNA表达水平呈正相关,与TMP1的mRNA表达水平呈负相关。以上结果表明,心房肌组织中MMP1/TMP1以及MMP9/TMP1的mRNA表达水平失衡引起I型胶原转录水平的改变,可能是慢性房颤患者心房肌间质纤维化的分子基础,在慢性房颤的过程中,MMPs的mRNA在左、右心房的表达是有差异的。
The aim of this study was to investigate whether there is a difference in the mRNA levels of atrial collagen, matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) in patients with chronic atrial fibrillation. A total of 45 patients undergoing open heart valve replacement surgery were selected, including 27 patients with chronic atrial fibrillation and 18 patients with sinus rhythm. Left and right atrial appendages were obtained during operation. Semi-quantitative RT-PCR was used to detect type I collagen , Type III collagen, matrix metalloproteinase-1, 9 (MMP1, MMP9), and matrix metalloproteinase inhibitor-1 (TMP1). The results showed that: (1) Compared with sinus rhythm group, the mRNA expression of type I collagen, MMP1 and MMP9 in the left and right atria of chronic atrial fibrillation group were significantly increased (P <0.05), and the expression levels of TMP1 (P <0.01). (2) There was no significant difference in mRNA expression of type I collagen, type III collagen, MMP1, MMP9 and TMP1 between the left and right atrium muscles in sinus rhythm group > 0.05). (3) The mRNA expression of MMP1 in chronic atrial fibrillation group was higher than that of the left atrium in right atrial muscle tissue (P <0.05). The mRNA expression of MMP9 in left atrium was higher than that in right atrium <0.01). (4) The mRNA expressions of MMP1 and MMP9 in both left atrium and right atrium were positively correlated with the mRNA expression of type I collagen and negatively correlated with the expression of TMP1 mRNA. The above results indicate that the imbalance of mRNA expression of MMP1 / TMP1 and MMP9 / TMP1 in atrial myocardium causes the change of type I collagen transcription and may be the molecular basis of atrial fibrosis in patients with chronic atrial fibrillation. In the process, the expression of MMPs mRNA in left and right atrium is different.