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目的:探讨OPG/RANK/RANKL轴与二尖瓣合并永久性房颤患者术后自动转复的窦性心律稳定性的关系及其临床意义。方法:选取135例在行单纯二尖瓣置换术后自动复律的房颤患者,根据术后7 d内房颤是否复发分为房颤(AF)组和窦性心律(SR)组。术中取右心耳组织,采用Western blot及免疫组织化学法检测组织中OPG、RANK、RANKL的表达,用Masson三色法检测组织中间质纤维化程度。结果:AF组RANK和RANKL表达水平以及RANKL/OPG比值均高于SR组,胶原容积分数(CVF)在SR组显著低于AF组,RANK、RANKL表达水平以及RANKL/OPG比值与CVF呈显著正相关。结论 :OPG/RANK/RANKL轴可能参与了二尖瓣合并房颤患者术后房颤的复发,因此可作为房颤上游治疗一新靶点。
OBJECTIVE: To investigate the relationship between the OPG / RANK / RANKL axis and sinus rhythm stability of patients with mitral valve regurgitation and permanent AF and their clinical significance. Methods: A total of 135 patients with AF undergoing spontaneous cardioversion after simple mitral valve replacement were enrolled in this study. Patients were divided into AF group and sinus rhythm group (SR) according to whether recurrence of atrial fibrillation occurred within 7 days. The right atrial appendage was removed and the expression of OPG, RANK and RANKL was detected by Western blot and immunohistochemistry. The degree of interstitial fibrosis was detected by Masson’s trichrome. Results: The expression of RANK and RANKL and the ratio of RANKL / OPG in AF group were significantly higher than those in SR group. The collagen volume fraction (CVF) in SR group was significantly lower than that in AF group. The expression of RANK, RANKL and RANKL / OPG were positively correlated with CVF Related. Conclusion: The OPG / RANK / RANKL axis may be involved in the recurrence of atrial fibrillation in patients with mitral valve disease and atrial fibrillation. Therefore, it may serve as a new target for the treatment of atrial fibrillation.