發(fā)布時(shí)間：2018-08-30 14:11

【摘要】：目的:觀察MMP-9在老年風(fēng)濕性心臟病(風(fēng)心病)心房纖顫(房顫)患者心房纖維化的表達(dá),探討MMP-9與老年風(fēng)心病房顫患者心房纖維化的關(guān)系。方法:選取西安交通大學(xué)第一附屬院、西京醫(yī)院、陜西省人民醫(yī)院心臟外科2012年5月28日至2012年8月13日因風(fēng)濕性心臟瓣膜病住院進(jìn)行心臟瓣膜置換手術(shù)的患者32例,根據(jù)有無(wú)房顫分為兩組:慢性房顫組16例;竇性心律組16例。收集上述患者基本臨床資料,如年齡、性別、血壓、現(xiàn)病史、心電圖及心臟彩超等資料。所有患者于心臟外科手術(shù)中建立體外循環(huán)心臟停跳前,在體外循環(huán)插管前及右心房打開(kāi)后獲取右心房組織(0.3-0.5cm3),采用HE染色、Masson染色觀察兩組心肌纖維化程度,采用實(shí)時(shí)熒光定量多聚核苷酸鏈?zhǔn)綉?yīng)反技術(shù)(RT-q PCR)檢測(cè)心房組織中Ⅰ、Ⅲ型膠原的m RNA水平,采用免疫印跡試驗(yàn)(Western blotting)測(cè)定心房組織MMP-9的表達(dá)。結(jié)果:(1)HE染色結(jié)果顯示與竇性心律組患者相比,房顫組患者心房肌纖維增粗、排列松散不齊,可見(jiàn)明顯纖維組織增生。Masson染色結(jié)果顯示與竇性心率組患者相比,房顫組患者心房組織中出現(xiàn)粗細(xì)不均的藍(lán)色膠原纖維組織,心肌間質(zhì)膠原沉積顯著增多;房顫組心房組織膠原容積分?jǐn)?shù)顯著高于竇性心律組,組間比較有統(tǒng)計(jì)學(xué)差異(P0.05)。(2)房顫組心房肌組織標(biāo)本中Ⅰ型膠原的m RNA相對(duì)表達(dá)明顯高于竇性心率組;心房肌組織標(biāo)本中Ⅲ型膠原的m RNA相對(duì)表達(dá)雖然在房顫組中較竇性心律組增高,但組間比較無(wú)統(tǒng)計(jì)學(xué)差異。(3)房顫組心房組織MMP-9蛋白表達(dá)水平高于竇性心律組(P0.05);房顫組MMP-9蛋白表達(dá)水平與I型膠原m RNA、左和右房?jī)?nèi)徑均呈明顯正相關(guān)(r分別為0.511、0.534、0.736,均P0.05)。結(jié)論:老年風(fēng)心病房顫患者心房組織中MMP-9的蛋白表達(dá)變化是房顫患者心房纖維化的分子機(jī)制之一,與房顫的發(fā)生與維持有關(guān)。
[Abstract]:Aim: to observe the expression of MMP-9 in atrial fibrillation (AF) in elderly patients with rheumatic heart disease (RHD) and to investigate the relationship between MMP-9 and atrial fibrosis in elderly patients with rheumatic heart disease (RHD). Methods: from May 28, 2012 to August 13, 2012, 32 patients with rheumatic valvular valve replacement were selected from the first affiliated Hospital of Xi'an Jiaotong University, Xijing Hospital and Shaanxi Provincial people's Hospital. The patients were divided into two groups according to atrial fibrillation: chronic atrial fibrillation group (16 cases) and sinus rhythm group (16 cases). Basic clinical data such as age, sex, blood pressure, current history, electrocardiogram and echocardiography were collected. Before cardiopulmonary bypass (CPB) cardiac arrest was established in all patients, right atrial tissue (0.3-0.5cm3) was obtained before CPB catheterization and right atrium was opened. The degree of myocardial fibrosis was observed by HE staining and Masson staining. Real-time fluorescence quantitative polynucleotide chain reaction (RT-q PCR) technique was used to detect the m RNA level of type 鈪，

本文編號(hào)：2213310