二尖瓣手术和金葡菌血症后左心室细胞粘附分子的基因表达  

Gene expressions of cell adhesion molecules in left ventricular myocardium after mitral valve surgery and staphylococcus aureus bacteremia

作　　者：赵波[1] 孙威[1] 付向宁[1] 陈启福[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院胸心外科,湖北武汉430030

出　　处：《新乡医学院学报》2005年第6期552-554,共3页Journal of Xinxiang Medical University

摘　　要：目的探讨二尖瓣手术/金葡菌血症对左心室组织部分细胞粘附分子和炎症细胞因子mRNA转录调节的影响。方法24只家兔分别行二尖瓣手术,经静脉注射金葡菌(5×106CFU.ml-1)和二尖瓣手术合并金葡菌注射,术后6 h提取左心室组织RNA,RT-PCR技术检测内皮白细胞粘附分子-1(E-Selectin)、血小板内皮细胞粘附分子-1(PECAM-1)、和血管细胞粘附分子-1(VCAM-1)mRNA表达水平,与正常家兔相比较。结果单独金葡菌血症未引起左心室靶基因的明显变化;二尖瓣手术后左心室组织E-Selectin和PECAM-1 mRNA表达水平明显升高,VCAM-1mRNA无明显变化;二尖瓣手术合并金葡菌注射后左心室组织E-Selectin mRNA明显调高表达,而PECAM-1和VCAM-1 mRNA明显调低表达。结论在二尖瓣手术和菌血症早期只有手术刺激导致部分特定的细胞粘附分子高表达,并在感染性心内膜炎的炎性反应进程中起主要作用;左心室组织细胞粘附分子的不均衡分布可能是由于不同的信号转导途径所致。Objective To investiagte the effects of bacteraemia and mitral valve surgery isolated and in combination as promoting factors for transcriptional regulation of various cell adhesion molecules （E-Selectin, PECAM-1, VCAM-1） in the left ventricle of rabbits. Methods Seven rabbits received 5×10^6 colony forming units staphylococcus aureus i.v., while 9 rabbits underwent mitral surgery, 8 rabbits underwent both interventions in combination. The hearts were explanted 6h after the intervention and the tissue was shock frozen in liquid nitrogen. Total RNA was isolated and mRNA abundance determined by semiquantitative duplex RT-PCR using 18S RNA as internal contol. Results were compared with a contol group consisting of 7 untreated rabbits. Results The bacteraemia did not lead to upregulated mRNA levels of any studied molecules, while mitral surgery caused significantly higher relative expression levels of E-Selectin and PECAM-1 （P〈0.05）, but not of VCAM-1 （P〉0.05）. The combination of bacteremia and mitral surgery causes an uneven expression pattern with a significant upregulation for E-Selectin and a downregulation for PECAM-1 and VCAM-1 （P〈0.05）. Conclusion Within 6h after bacterial or surgical stimulus,only the isolated surgical procedure results in an upregulation of specific cell adhesion molecules,and therefore might be considered as a main trigger for inflammatory processes, e.g. the development of endocarditis. The expression pattern in the group treated with bacteraemia and surgical intervention could possibly be explained with a different utilization of transcription ways.

关 键 词：二尖瓣手术 金黄色葡萄球菌 粘附分子 兔 心脏 

分 类 号：R654.2[医药卫生—外科学]