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目的探讨二尖瓣病变患者赖氨酸氧化酶(lysyl oxidase,LOX)表达与持续性心房颤动(atrial fibrillation,AF)的关系。方法 2012年3月至2014年2月纳入我院拟行瓣膜置换术187例二尖瓣膜病变患者。根据是否伴有持续性AF,将研究患者分为窦性心律(sinus rhythm,SR)组和AF组。在AF组,根据患者的二尖瓣病变类型,进一步分组为二尖瓣狭窄(mitral stenosis,MS)伴AF组(MS+AF组)和二尖瓣反流(mitral regurgitation,MR)伴AF组(MR+AF组)。AF组97例,男44例、女53例,年龄(52.76±11.35)岁;SR组90例,男48例、女42例,年龄(47.95±14.22)岁。结果二尖瓣病变患者中51.87%(97/187)伴有AF,与二尖瓣反流相比,二尖瓣狭窄较多伴有持续性AF(60.31%vs.34.43%,P<0.05)。AF组血浆LOX表达水平明显高于SR组(73.78±25.42IU/L vs.51.05±18.96 IU/L,P<0.05)。在AF患者中,MS组的LOX水平高于MR组(84.21±32.15 IU/L vs.59.74±35.21IU/L,P<0.05)且易伴有血栓。多元回归分析结果显示:AF与LOX水平(r=0.124,P=0.036)及左心房直径(r=0.531,P=0.042)有关。结论二尖瓣病变患者血浆LOX水平升高与AF发生有关,二尖瓣狭窄患者尤为明显。
Objective To investigate the relationship between the expression of lysyl oxidase (LOX) and persistent atrial fibrillation (AF) in patients with mitral valve disease. Methods March 2012 to February 2014 included in our hospital proposed valve replacement 187 cases of mitral valve disease. Patients were divided into sinus rhythm (SR) group and AF group according to whether they had persistent AF. In the AF group, mitral stenosis (MS) group was further divided into AF group (MS + AF group) and mitral regurgitation (MR) group with AF according to the type of mitral valve disease (MR + AF group). There were 97 males and 44 females and 53 females with an average age of 52.76 ± 11.35 years in the AF group. There were 90 males and 48 females in the SR group, with 42 females and a mean age of 47.95 ± 14.22 years. Results There were 51.87% (97/187) AFs in patients with mitral valve disease. Compared with mitral regurgitation, mitral valve stenosis had more persistent mitral stenosis (60.31% vs.34.43%, P <0.05) . The level of LOX in AF group was significantly higher than that in SR group (73.78 ± 25.42 IU / L vs.51.05 ± 18.96 IU / L, P <0.05). In patients with AF, LOX levels in MS group were significantly higher than those in MR group (84.21 ± 32.15 IU / L vs 59.19 ± 35.21 IU / L, P <0.05) and were associated with thrombus. Multiple regression analysis showed that AF correlated with LOX level (r = 0.124, P = 0.036) and left atrial diameter (r = 0.531, P = 0.042). Conclusions The elevated plasma LOX in patients with mitral valve disease is associated with AF, especially in patients with mitral stenosis.