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目的探讨阵发性室上性心动过速(PSVT)患者射频消融后有无干细胞动员及机制。方法连续收集实施射频消融的 PSVT 患者 20 例。采集射频消融前及其后第 1 天的外周血,使用流式细胞仪检测 CD117+ 单个核细胞、CXCR4+ 单个核细胞、CD133+ CD34+ 单个核细胞比例,采用酶联免疫法(ELISA)检测基质金属蛋白酶-9(MMP-9)、人生长调节致癌基因β/黑素瘤生长刺激因子(GR0β)、基质细胞衍生因子 1(SDF-1)、白细胞介素 6(IL-6)、白细胞介素 8(IL-8) 、粒细胞集落刺激因子(G-CSF)、血管紧张素 1(ANG1)、cTnT及 CK-MB 等。结果 PSVT 患者射频消融后 cTnT 及 CK-MB 显著增高(0.01 ± 0.047 ng/ml vs 0.195 ± 0.038 ng/ml,P<0.001 ;12.5 ± 3.75 u/l vs 15.40 ± 1.03 u/l, P=0.016)。MMP-9 术后较术前明显增高(23.265±3.922 ng/ml vs 35.082 ± 5.435 ng /ml, P<0.001),其余细胞因子均无明显变化。cTnT(R=0.544,P=0.013)及 CK-MB(R=0.519,P=0.019) 与 CD133+ CD34+ 单个核细胞比例呈正相关,但外周血无 CD117+单个核细胞、CXCR4+ 单个核细胞、CD133+ CD34+ 单个核细胞动员。结论 PSVT 患者射频消融导致心肌损伤及 MMP-9 显著增高 , 但损伤程度尚不足以动员 CD117+ 单个核细胞、CXCR4 + 单个核细胞、CD133+ CD34+ 单个核细胞。
Objective To investigate whether or not stem cell mobilization and its mechanism after radiofrequency catheter ablation in patients with paroxysmal supraventricular tachycardia (PSVT). Methods Twenty consecutive PSVT patients undergoing RFA were collected. Peripheral blood samples were collected before and after radiofrequency ablation. The proportion of CD117 + mononuclear cells, CXCR4 + mononuclear cells and CD133 + CD34 + mononuclear cells were measured by flow cytometry. The levels of MMP- 9 (MMP-9), human growth regulatory oncogene β / melanoma growth stimulating factor (GR0β), stromal cell derived factor 1 (SDF-1), interleukin 6 (IL-6), interleukin 8 IL-8), granulocyte colony-stimulating factor (G-CSF), angiotensin 1 (ANG1), cTnT and CK-MB. Results The cTnT and CK-MB were significantly increased in patients with PSVT after radiofrequency ablation (0.01 ± 0.047 ng / ml vs 0.195 ± 0.038 ng / ml, P <0.001; 12.5 ± 3.75 u / l vs. 15.40 ± 1.03 u / . MMP-9 was significantly higher than that before operation (23.265 ± 3.922 ng / ml vs 35.082 ± 5.435 ng / ml, P <0.001), and no significant changes were found in other cytokines. There was a positive correlation between cTnT (R = 0.544, P = 0.013) and CK-MB (R = 0.519, P = 0.019) and the proportion of CD133 + CD34 + mononuclear cells in peripheral blood without CD117 + mononuclear cells, CXCR4 + mononuclear cells, CD133 + CD34 + Nuclear cell mobilization. Conclusions RFI results in a significant increase of myocardial injury and MMP-9 in PSVT patients, but the degree of injury is not enough to mobilize CD117 + mononuclear cells, CXCR4 + mononuclear cells and CD133 + CD34 + mononuclear cells.