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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。
Objective To investigate the correlation between the mRNA expression of MMPs and TIMPs in myocardium and the population of atrial fibrillation in China. Methods From January 2001 to May 2014, Pubmed, Web of Science, CNKI and Wanfang database were searched to study the population of patients with atrial fibrillation and sinus rhythm who underwent cardiac surgery. The left and right atrial or left atrial appendage Myocardial tissue, detection of MMPs and TIMPs mRNA expression in atrial fibrillation group and sinus rhythm difference. Results Nine meta-analyzes included meta-analysis. The mRNA expression of MMP-1 in atrial fibrillation group was significantly higher than that in sinus rhythm group (SMD = 0.48, 95% CI: 0.20-0.76, P <0.01). The mRNA expression of MMP-9 in atrial fibrillation group was significantly higher than that in sinus rhythm group (SMD = 1.11, 95% CI: 0.75-1.46, P <0.01). TIMP-1 mRNA expression in atrial fibrillation group than in sinus rhythm group no significant difference (SMD = -0.56,95% CI: -1.77 ~ 0.65, P = 0.37). TIMP-2 mRNA expression in atrial fibrillation group than the sinus rhythm group no significant difference (SMD = 0.31,95% CI: -1.16 ~ 1.78, P = 0.68). Conclusions Atrial fibrosis plays an important role in the occurrence and maintenance of atrial fibrillation. MMP-1 and MMP-9 play an important role in the fibrosis of atria, and the increase of transcriptional level ameliorates the occurrence of atrial fibrillation and atrial fibrillation Structural remodeling, and the role of TIMPs in atrial fibrillation remains controversial.