慢性阻塞性肺病患者膈肌肌凝蛋白重链表型的变化  

Changes of myosin heavy chain phenotype in diaphragm of chronic obstructive pulmonary disesae patients

作　　者：白冲[1] 陈若华[2] 陆方林[3] 黄盛东[3] 商艳[1] 马凌云[1] 李强[1] 刘忠令[1] 

机构地区：[1]第二军医大学长海医院呼吸内科,上海200433 [2]长海医院儿科 [3]长海医院胸心外科

出　　处：《第二军医大学学报》2004年第7期733-736,共4页Academic Journal of Second Military Medical University

基　　金：国家自然科学基金 ( 3 990 0 0 66)

摘　　要：目的 :研究以呼吸负荷和肺容量慢性增加为特点的慢性阻塞性肺病 (COPD)患者膈肌中肌凝蛋白表型的变化。 方法 :2 4例患者经开胸手术取膈肌标本。通过非变性电泳、SDS-聚丙烯酰胺凝胶电泳结合 Western印迹分析检测膈肌肌凝蛋白重链 (m yosin heavy chain,MHC)各种异构体组分改变。分析患者第 1秒用力肺活量 (FEV1 )、肺总量 (TL C)和功能残气量(FRC)等检测结果与慢 MHC(β- MHC)占总 MHC比例的相关性。 结果 :慢性过度负荷与 β- MHC比例增加 ,快 MHC比例减少有关 ;COPD患者 β- MHC比例为 (75 .36± 9.0 0 ) % ,明显高于对照组的 (5 0 .0 0± 4 .81 ) % (P<0 .0 1 ) ;β- MHC比例与 FEV1呈线性负相关 (r=- 0 .89,P<0 .0 1 ) ,与 TL C呈线性正相关 (r=0 .6 0 ,P<0 .0 1 ) ,与 FRC呈线性正相关 (r=0 .74 ,P<0 .0 1 )。结论 :COPD患者快肌凝蛋白比例减少而慢肌凝蛋白比例增加 ,这种改变与肺过度充气有关 。Objective:To study the phenotype changes of myosin heavy chain(MHC)in the diaphragm of severe chronic obstructive pulmonary disease(COPD)patients characterized by chronic increase in respiratory load and lung volume.Meth-ods:Diaphragm biopsies were obtained from24patients underwent thoracic surgery.MHC isoforms were analyzed with elec-trophoresis in non-denaturing conditions,SDS-glycerol PAGE,and Western blotting.Forced expiratory volume in1s (FEV 1 ),total lung capacity(TLC),and functional residual capacity(FRC)of the24patients were measured before surgery.Results:Human diaphragm contained at least4myosin isoforms(1slow and3fast).Chronic overload was associated with the increase in the percentage of slow β-MHC and fast MHC.β-MHC in emphysematous patients was(75.36±9.00)%,much higher than that in control group(50.00±4.81)%(P<0.01).Linear correlations were found between β-MHC percentage and FEV 1 (r=-0.89,P<0.01),TLC(r=0.60,P<0.01),and FRC(r=0.74,P<0.01).Conclusion:The human adult diaphragm is composed of a balanced proportion of slow and fast myosin isoforms.In COPD patients,fast myosins decreases and slow myosins increases,which may be related to lung hyperinflation and reflect an adaptation of the diaphragm to the new functional requirements.

关 键 词：肺疾病 阻塞性 膈肌 肌凝蛋白重链 表型 

分 类 号：R563[医药卫生—呼吸系统]