RAAS(血管紧张素肾素醛固酮系统与心房颤动的关系研究.doc

RAAS（血管紧张素－肾素－醛固酮系统与心房颤动的关系研究 北京友谊医院心血管疾病诊治研究中心 邢云利 ? 中文摘要背景：随着人口老龄化的加剧，房颤的发生率，致残、致死率逐年增加。目前房颤发生机制尚不清楚，治疗效果不佳。研究表明心房重构，特别是结构重构是房颤发生、发展和复发的基质。其病理表现为心房的肥厚、扩大及纤维化，影响心脏传导和不应期，促进房颤的发生和维持，是近年研究的热点。流行病学、临床和基础研究提示炎症可能与心房的结构重构相关。我中心曾入选42例患者进行研究,发现慢性房颤患者血浆RAAS各组分较窦性心律明显升高,并与左房直径正相关。本研究进一步扩大样本量，评估RAAS对心房结构重构以及房颤发生的影响。方法和结果：入选97例患者，将其分为窦性心律组（SR,n=31），阵发房颤组(PAF,n=34)和持续房颤组(CAF,n=32)。比较各组血浆肾素，血管紧张素II以及醛固酮水平，及其与左房直径的关系。结果显示CAF组患者平均左房直径与SR组和PAF组相比均明显增大（p0.01），血浆肾素、AngⅡ、Ald浓度较SR组明显升高(p0.05)。左心房直径与血浆RAAS各组分有明显正相关关系（p0.05）。结论: 肾素－血管紧张素－醛固酮系统(RAAS)可能参与了房颤心房结构重构。关键词：房颤，结构重构，血管紧张素－肾素－醛固酮系统，左心房直径Research on the relationship between RAAS (renin- angiotension-aldosterone system) and atrial fibrillationAbstractBackground：In the aging society, the mobility and mortality of atrial fibrillation increase. However，the machanism of atrial fibrillation are still unclear.and the therapy are not efficient. It is well known that atrial remodeling ,especially structural remodeling is the basis of occurrence 、development and recurrence of atrial fibrillation .It mainly shows the enlargement and fibrosis of myocardia, affecting conduction and refractory period. Structual remodeling accelerates the occurrence and maintenance of atrial fibrillation ,and is regarded as current research hotspots. From the points of epidemiological, clinical and basic research, inflammation may involve the structural remodeling. So comparing renin-angiotensio、aldosterone and left atria diameter between atrial fibrillation and sinus rhythm, paroxysmal and persistent fibrillation , our study try to know the effects of inflammation on structural remodeling and atrial fibrillation. Methods and Results：Enrolled 97 patients were divided into three groups: sinus rhythm group (SR,n=31), paroxysmal atrial fibrillation (PAF,n=34), and chronic atrial fibrillation group (CAF,n=32).Compare renin-angiotensio、aldosterone and left atria diameter in different groups and know the relationship between them. The results show t