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目的:探讨血浆基质金属蛋白酶2(MMP-2)对心房颤动(房颤)患者导管射频消融术后房颤复发的影响。方法:102例行射频消融术治疗的阵发性房颤患者,根据术后6个月内房颤是否复发将患者分为维持窦律组(83例)和房颤复发组(19例),两组患者分别于术前和术后6个月检测血浆MMP-2及其抑制剂组织型基质金属蛋白酶抑制因子(TIMP-2)浓度。结果:与维持窦律组相比较,房颤复发组患者术前血浆MMP-2水平明显增高[(856.6±115.6)ng/ml:(748.0±109.3)ng/ml,P<0.05],而TIMP-2的血浆水平两组之间差异无统计学意义。MMP-2与TIMP-2水平也无相关性(r=0.182,P=0.27)。多因素回归分析表明预测消融后房颤复发的独立危险因素是术前MMP-2浓度(OR=4.82,95%CI 1.1~18.0,P=0.002)、左房内径(OR=2.441,95%CI1.27~5.81,P=0.019)。结论:术前血浆MMP-2浓度对预测射频消融术后房颤复发具有一定的临床应用价值。
Objective: To investigate the effect of matrix metalloproteinase-2 (MMP-2) on the recurrence of atrial fibrillation after radiofrequency catheter ablation in patients with atrial fibrillation (AF). Methods: A total of 102 patients with paroxysmal atrial fibrillation undergoing radiofrequency catheter ablation were divided into maintenance sinus rhythm group (n = 83) and atrial fibrillation recurrence group (n = 19) according to whether recurrence of atrial fibrillation within 6 months after operation. The levels of tissue inhibitor of metalloproteinase-2 (TIMP-2) and MMP-2 in the two groups were measured before and 6 months after operation. Results: Compared with the maintenance of sinus rhythm group, the level of MMP-2 in preoperative atrial fibrillation recurrence group was significantly higher than that in the control group (856.6 ± 115.6) ng / ml (748.0 ± 109.3) ng / ml, P <0.05] -2 plasma levels between the two groups, the difference was not statistically significant. There was also no correlation between MMP-2 and TIMP-2 levels (r = 0.182, P = 0.27). Multivariate regression analysis showed that the independent risk factors for predicting the recurrence of atrial fibrillation after ablation were preoperative MMP-2 concentration (OR = 4.82, 95% CI 1.1-18.0, P = 0.002), left atrium diameter (OR = 2.441, 95% CI1 .27 ~ 5.81, P = 0.019). Conclusion: Preoperative plasma MMP-2 concentration has certain clinical value in predicting the recurrence of atrial fibrillation after radio-frequency ablation.