CHD合并PH患者血浆ET-1浓度与肺血管C-MYC癌基因表达的关系  

Study of the concentration of plasma ET-1 and C-MYC gene in the pulmonary of patients with congenital heart disease associated with pulmonary hypertension

作　　者：付静[1] 马增山[1] 马胜军[1] 董铭峰[1] 刘桂清[1] 

机构地区：[1]聊城市人民医院,山东省聊城市252000

出　　处：《中国心血管病研究》2006年第8期568-570,共3页Chinese Journal of Cardiovascular Research

基　　金：山东省科学技术厅星火计划资助项目(022130361)

摘　　要：目的探讨内皮素(ET-1)、C-MYC癌基因在先天性心脏病(CHD)合并肺动脉高压(PH)形成过程中的生物作用。方法42例左向右分流CHD患者,根据肺动脉平均压(MPAP)的高低分为三组,正常组:MPAP<20mmHg,11例;肺动脉高压组:MPAP>20mmHg,22例;重度肺动脉高压组:MPAP>70mmHg,9例。采用放免法测定血浆ET-1浓度。所有病例均行肺活检术,标本常规制成蜡块,应用免疫组化方法,单克隆抗C-MYC基因蛋白抗体作一抗,观察肺组织中C-MYC癌基因的定位及表达。结果C-MYC癌基因主要分布于肺动脉内皮细胞、平滑肌和成纤维细胞等细胞的胞核中。血浆ET-1浓度和C-MYC癌基因表达各组之间差异有统计学意义(P<0.05),各病理分级之间差异有统计学意义(P<0.05),随着肺小动脉病理分级的加重而升高,并且二者的表达与病理分级有明显的相关性(P<0.05)。结论ET-1和C-MYC癌基因在CHD合并PH的形成过程中起着重要的生物学作用,ET-1可以刺激C-MYC癌基因的表达,进而促进平滑肌细胞和成纤维细胞增殖。Objective To study the concentration of plasma ET-1 and expression of C-MYC gene in the pulmonary of patients with congenital heart disease associated with pulmonary hypertension and its significance and the relationship in the concentration of plasma ET-1 and expression of C-MYC gene and pathological behavior of grading and staging of hyper-kinesic pulmonary hypertension. Methods 42 patients with CHD were divided into Ihree groups, no-PH group （11 patients ）, with preoperative mean pulmonary artery pressure （MPAP） 〈20 mm Hg; PH group： （22 patients）, with preoperative MPAP〉20 mm Hg, and cyanosis group （9 patients）, with preoperative MPAP〉70 mm Hg. The lung tissue samples were examined from 42 patients by surgical biopsy of lung .Lung tissue was examined for expression of C-MYC by immunohistochemical technique. Pathological grading of pulmonary vascular changes was standardized by Heath-Edwards. Radio-immunal assay was used to determine the concentration of plasma ET-1. Results There is expression karyon of endotheliocyte,smooth muscle cell and growth fibrin cell of pulmonary C-MYC gene staining.The concentration of ET-1 and the expression of C-MYC in the lung tissues of PH groups were increased graduslly.The expression of C-MYC in the lung tissues in all pathological degree groups showed statistic differences（P〈0.05 ）. The concentration of plasma ET-1 was correlative with positive expression of c-myc gene （P〈0.05）. Conclusion The finding confirmed that ET-1 and C-MYC gene have an important biological behavior in the process of formed pulmonary hypertension of congenital heart disease and the ET-1 could activate expression of C-MYC gene. They improve proliferation of smooth muscle cell and growth fibrin cell.

关 键 词：内皮缩血管肽1 癌基因 肺动脉高压 心脏缺损 先天性 

分 类 号：R543.2[医药卫生—心血管疾病] R541.1[医药卫生—内科学]