Effects of myocardiac fibrosis indicators on patients with sick sinus syndrome
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摘要:
目的：筛选反映病态窦房结综合征患者心房纤维化程度的血液学指标。方法：连续入选南京江宁医院心内科2017年1月—2018年1月的95例患者。按照动态心电图结果分为正常对照组50例（对照组），病态窦房结综合征患者45例（病窦组）；男44例，女51例，年龄40~80岁。完善心脏彩超、动态心电图检查，测定血清中转化生长因子-β1（transforming growth factor-beta 1，TGF-β1）、前胶原蛋白C肽末端-Ⅰ（propeptide of type Ⅰ procollagen，PINP）和前胶原蛋白C肽末端-Ⅲ（procollagen Ⅲ N-terminal propeptide，PⅢNP）、血浆利钠尿肽前体（N-terminal pro-brain natriuretic peptide，NT-proBNP）水平，并测量心电图下壁Ⅱ导联P波的振幅，比较对照组和病窦组患者各指标间的差异。结果：两组年龄、性别、尿酸、血糖、血脂、左右房内径差异无明显统计学意义，但是病窦组心电图Ⅱ导联P波的振幅明显低于正常组［（0.09±0.01）cm vs.（0.15±0.02）cm，P=0.001］。研究发现病窦组血TGF-β1（P=0.002）、PⅢNP（P=0.017）、NT-proBNP（P=0.001）水平明显高于对照组，且差异有统计学意义。1年后的随访发现，与对照组相比，病窦组TGF-β1、PⅢNP、NT-proBNP以及心电图下壁Ⅱ导联P波振幅的变化更加明显。结论：心肌纤维化指标TGF-β1、NT-proBNP、PⅢNP水平及心电图Ⅱ导联P波振幅与病态窦房结综合征的发生有相关性，可用于病态窦房结综合征的早期发现及预后判断。
Abstract:
Objective：This study aims to screen some effective indicator to foretell the extent of atrial fibrosis in patients with sick sinus syndrome（SSS）. Methods：Total 95 patients were 40-80 years old，who were consecutively enrolled in cardiovascular department of the Affiliated Jiangning Hospital of Nanjing Medical University from January 2017 to January 2018，and were divided into two groups. One group is control，another group is patients who were diagnosed as SSS. All the patients received echo-cardiogram and dynamic electrocardiogram examination. And transforming growth factor-beta 1（TGF-β1），N-terminal pro-brain natriuretic peptide（NT-proBNP），propeptide of type Ⅰ procollagen（PINP），procollagen Ⅲ N-terminal propeptide（PⅢNP） in the blood of these patients were also measured. Besides，the amplitude of P wave in lead Ⅱ were measured in electrocardiogram of every patient. Then，differences in all parameters between the two groups were compared. Results：There were no statistical differences in age，sex，uric acid，blood glucose and diameter of left or right atrial between two groups，but the amplitude of P wave in electrocardiogram of SSS group was significantly lower than that of control group［（0.09±0.01）cm vs.（0.15±0.02）cm，P=0.001］. The levels of TGF-β（P=0.002），PⅢNP（P=0.017），NT-proBNP（P=0.001） in SSS group obviously higher than those in control group. Besides，after one year’s follow-up，the variation of TGF-β1，PⅢNP，NT-proBNP and the amplitude of P wave in lead Ⅱ between SSS and healthy control group has statistical significance. Conclusion：The levels of TGF-β1，PⅢNP，NT-proBNP in serum and the amplitude of P wave in electrocardiography can predict the morbidity and development of SSS
