山东大学学报(医学版) ›› 2015, Vol. 53 ›› Issue (1): 47-53.doi: 10.6040/j.issn.1671-7554.0.2014.485
张伶俐, 周莹, 李小荷, 李慧, 钟明, 张薇
ZHANG Lingli, ZHOU Ying, LI Xiaohe, LI Hui, ZHONG Ming, ZHANG Wei
摘要: 目的 探讨心肌组织中MMPs、TIMPs的 mRNA表达水平与中国房颤人群的相关性。方法 检索2001年1月至2014年5月Pubmed, Web of Science, CNKI和万方数据库已发表文献,研究人群为经心脏外科手术的中国房颤与窦性心律患者,取左右心房或左右心耳的心肌组织,检测MMPs和TIMPs的mRNA表达水平在房颤组与窦性心律组的差别。结果 纳入9篇文献,通过荟萃分析发现,MMP-1的mRNA表达水平房颤组较窦性心律组明显增加(SMD=0.48, 95% CI:0.20~0.76, P<0.01)。MMP-9的mRNA表达水平房颤组较窦性心律组明显增加(SMD=1.11, 95% CI:0.75~1.46, P<0.01)。TIMP-1的mRNA表达水平房颤组较窦性心律组无明显差异(SMD=-0.56, 95% CI:-1.77~0.65, P=0.37)。TIMP-2的mRNA表达水平房颤组较窦律组无明显差异(SMD=0.31, 95% CI: -1.16~1.78, P=0.68)。结论 心房纤维化在房颤的发生和维持发挥着重要作用,基质金属蛋白酶中MMP-1和MMP-9影响心房的纤维化,其转录水平的升高促进房颤的发生,参与房颤的心房结构重构,而TIMPs在房颤中的作用尚存争议。
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[1] Khairy P, Nattel S. New insights into the mechanisms and management of atrial fibrillation[J]. CMAJ, 2002, 167(9):1012-1020. [2] van den Berg MP, van Gelder IC, van Veldhuisen DJ. Impact of atrial fibrillation on mortality in patients with chronic heart failure[J]. Eur J Heart Fail, 2002, 4(5):571-575. [3] Allessie M, Ausma J, Schotten U. Electrical, contractile and structural remodeling during atrial fibrillation [J]. Cardiovasc Res, 2002, 54(2):230-246. [4] Brundel BJ, Henning RH, Kampinga HH, et al. Molecular mechanisms of remodeling in human atrial fibrillation [J]. Cardiovasc Res, 2002, 54(2):315-324. [5] Xu J, Cui G, Esmailian F, et al. Atrial extracellular matrix remodeling and the maintenance of atrial fibrillation[J]. Circulation, 2004, 109(3):363-368. [6] Raffetto JD, Khalil RA. Matrix metalloproteinases and their inhibitors in vascular remodeling and vascular disease[J]. Biochem Pharmacol, 2008, 75(2):346-359. [7] Clark IM, Swingler TE, Sampieri CL, et al. The regulation of matrix metalloproteinases and their inhibitors [J]. Int J Biochem Cell Biol, 2008, 40(6-7):1362-1378. [8] Thomas CV, Coker ML, Zellner JL, et al. Increased matrix metalloproteinase activity and selective upregulation in LV myocardium from patients with end-stage dilated cardiomyopathy[J]. Circulation, 1998, 97(17):1708-1715. [9] Jeanine D Armiento. Matrix metalloproteinase disruption of the extracellular matrix and cardiac dysfunction[J]. Trends Cardiovasc Med, 2002, 12(3):97 -101. [10] Gomez DE, Alonso DF, Yoshiji H, et al. Tissue inhibitors of metalloproteinases: structure, regulation and biological functions [J]. Eur J Cell Biol, 1997, 74(2):111-122. [11] Roten L, Nemoto S, Sinsic J, et al. Effects of gene deletion of the tissue inhibitor of the matrix metalloproteinase-type 1 (TIMP-1) on left ventricular geometry and function in mice[J]. J Mol Cell Cardiol, 2000, 32(1): 109-120. [12] Higgins JPT, Green S. Cochrane Collaboration. Cochrane handbook for systematic reviews of interventions[M]. Chichester, England; Hoboken, NJ:Wiley-Blackwell, 2008. [13] 柯丹, 许春萱, 张建成, 等. 心房颤动患者心房组织中明胶酶的基因表达及活性变化[J]. 中华心血管杂志, 2005, 33(2):137-142. KE Dan, XU Chunxuan, ZHANG Jiancheng, et al. Changes in gelatinases expression and activity in human atria during atrial fibrillation[J]. Chin J Cardiol, 2005, 33(2):137-142. [14] 吕家高, 王岚, 陈运清, 等. 基质金属蛋白酶-1和基质金属蛋白酶-9及其抑制剂-1对心房颤动患者心房结构重构的影响[J]. 临床内科杂志, 2006, 23(4):276-278. LV Jiagao, WANG Lan, CHEN Yunqing, et al. Effects of matrix metalloproteinase-1,9 and tissue inhibitor-1 of metalloproteinase expression on human atrial structural remodeling during atrial fibrillation [J]. J Clin Intern Med, 2006, 23(4): 276-278. [15] 许静, 吴冬燕, 毛用敏, 等. 基质金属蛋白酶表达和活性改变同心房颤动患者心房纤维化的关系[J]. 中华心律失常学杂志, 2006, 10(5):345-348. XU Jing, WU Dongyan, MAO Yongmin, et al. The relationship between atrial fibrosis and matrix metalloproteinases in human atria with atrial fibrillation [J]. Chin J Cardiac Arrhyth, 2006, 10(5):345-348. [16] 王蔚, 吴平生, 杨希立. 基质金属蛋白酶及其抑制剂对心房颤动心房结构重构的影响[J]. 南方医科大学学报, 2010, 30(5):1160-1162. WANG Wei, WU Pingsheng, YANG Xili. Role of matrix metalloproteinase and tissue inhibitor of metalloproteinase in atrial structural remodeling in patients with atrial fibrillation [J]. J South Med Univ, 2010, 30(5):1160-1162. [17] 许国军, 甘天翔, 汤宝鹏, 等. 慢性房颤患者左右心房胶原和基质金属蛋白酶表达差异[J]. 生理学报, 2009, 61(3):211-216. XU Guojun, GAN Tianxiang, TANG Baopeng, et al. Differential expression of collagen and matrix metalloproteinases between left and right atria in patients with chronic atrial fibrillation[J]. Acta Physiologica Sinica, 2009, 61(3):211-216. [18] 王蔚, 杨希立. 基质金属蛋白酶及脑利钠肽对心房颤动患者心房重构的影响[J]. 中国医药导报, 2012, 9(16):71-74. WANG Wei, YANG Xili. Effects of matrix metalloproteinase and B-type natriuretic peptide expression on atrial structural remodeling with atrial fibrillation [J]. China medical herald, 2012, 9(16):71-74. [19] 陈运清, 王琳, 殷跃辉, 等. 基质金属蛋白酶-1,9和金属蛋白酶组织抑制因子-1对心房结构重构的作用[J]. 上海医学, 2008, 31(1):55-58. CHEN Yunqing, WANG Lin, YIN Yuehui, et al. Role of matrix metalloproteinases 1 and 9 and tissue inhibitor of metalloproteinase 1 in atrial structure remodeling[J]. Shanghai Med J, 2008, 31(1):55-58. [20] 朱慧, 张薇, 郭辰虹, 等. 心房肌基质金属蛋白酶-9和组织金属蛋白酶抑制因子-1表达改变对房颤心房重构机制的研究[J]. 中华医学杂志, 2005, 85(1):45-48. ZHU Hui, ZHANG Wei, GUO Chenhong, et al. Differential gene expression during atrial structural remodeling in human left and right atrial appendages in atrial fibrillation [J]. National Medical Journal of China, 2005, 85(1):45-48. [21] 甘天翔, 汤宝鹏. 心脏瓣膜病慢性房颤患者心房肌间质纤维化分子机制研究[D]. 乌鲁木齐: 新疆医科大学, 2009. [22] 薛邦德, 周华富. 心房肌MMP-2及TIMP-2的表达改变对风心患者房颤心房结构重构机制的研究[D]. 南宁: 广西医科大学, 2008. [23] Davies MJ, Pomerance A. Pathology of atrial fibrillation in man [J]. Br Heart J, 1972, 34(5):520-525. [24] Everett TH 4th, Olgin JE. Atrial fibrosis and the mechanisms of atrial fibrillation. Heart Rhythm, 2007, 4(3suppl):24-27. [25] Kostin S, Klein G, Szalay Z, et al. Structural correlate of atrial fibrillation in human patients[J]. Cardiovasc Res, 2002, 54(2):361-379. [26] Xu J, Cui G, Esmailian F, et al. Atrial extracellular matrix remodeling and the maintenance of atrial fibrillation[J]. Circulation, 2004, 109(3):363-368. [27] Spinale FG. Myocardial matrix remodeling and the matrix metalloproteinases: influence on cardiac form and function[J]. Physiol Rev, 2007, 87(4):1285-1342. [28] Marchesi C, Dentali F, Nicolini E, et al. Plasma levels of matrix metalloproteinases and their inhibitors in hypertension: a systematic review and meta-analysis [J]. J Hypertens, 2012, 30(1):3-16. [29] 戴天医, 刘小慧. 基质金属蛋白酶/基质金属蛋白酶组织抑制剂与心房颤动[J]. 心血管病学进展, 2012, 33(2):185-188. DAI Tianyi, LIU Xiaohui. Matrix Metalloproteinases, Tissue Inhibitor of Metalloproteinases and Atrial Fibrillation[J]. Adv Cardiovasc Dis, 2012, 33(2):185-188. [30] 季芳, 张艳. 心肌的金属基质蛋白酶表达对房颤心肌重构的影响[J]. 辽宁中医药大学学报, 2007, 9(3):81-83. JI Fang, ZHANG Yan. Expression of Matrix Metalloproteinases in Myocardium Contributes To Human Myocardial Remodeling during Atrial Fibrillation [J]. Journal of Liaoning University of TCM, 2007, 9(3):81-83. [31] Lin CS, Pan CH. Regulatory mechanisms of atrial fibrotic remodeling in atrial fibrillation[J]. Cell Mol Life Sci, 2008, 65(10):1489-1508. [32] Hinton RB,Yutzey KE. Heart valve structure and function in development and disease[J]. Annu Rev Physiol, 2011, 73:29-46. [33] 隋玺仲, 高长青. 基质金属蛋白酶及其抑制剂在风湿性二尖瓣狭窄合并心房纤颤中的作用[J]. 解放军医学院学报, 2014, 35(5):500-502. SUI Xizhong, GAO Changqing. Effect of matrix metalloproteinases and tissue inhibitors of metalloproteinases on rheumatic mitral valve stenosis with atrial fibrillation [J]. Acad J Chin PLA Med Sch, 2014, 35(5):500-502. |
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