热休克蛋白70在心脏跳动中二尖瓣置换术心房肌细胞中的表达  

Expression and significance of heat shock protein 70 of atrial myocytes in beating heart mitral valve replacement

作　　者：李逢昌[1] 黄健辉[1] 何巍[2] 李世康[2] 

机构地区：[1]广西医科大学第五附属医院胸心外科,广西柳州545001 [2]广西医科大学第一附属医院胸心外科

出　　处：《中国医师进修杂志（外科版）》2008年第1期14-16,共3页Chinese Journal of Postgraduates of Medicine

基　　金：广西医疗卫生重点科研课题（重200501）

摘　　要：目的观察心脏跳动中二尖瓣置换术患者心房肌细胞热休克蛋白70（HSP70）的表达情况。方法将同期30例行二尖瓣置换术的风湿性心脏病患者随机分为两组，试验组（浅低温心脏跳动中施术组，16例）与对照组（传统中低温心脏停跳中施术组，14例）。分别于体外循环（CPB）前。拔除上腔静脉插管时留取右心房组织标本，采用Western blot法测定心房肌细胞HSP70的表达情况。结果对照组CPB前与CPB后心房肌细胞HS％的表达分别为（160．23±7．12）μg/ml、（165．25±6．29）μg/ml；试验组CPB前与CPB后分别为（163．59±6．35）μg/ml、（196．34±4．23）μg/ml。与CPB前比较，试验组CPB后心房肌细胞HSP70的表达明显升高（P〈0．01）；而对照组CPB前后，心房肌细胞HSP70虽有所表达，但差异无统计学意义（P〉0．05）；两组CPB后心房肌细胞HSP70的表达，试验组要比对照组高（P〈0．05）。结论在心脏跳动中施术能较好地诱发HSP70高表达从而具有较好的心肌保护效果，此术式对心肌细胞的缺血-再灌注损伤要比传统手术小。Objective To observe the expression of atrial myocytes heat shock protein 70 （HSPTo） of patients with mitral valve replacement （MVR） in beating heart. Methods Thirty patients with mitral valvular heart disease were divided into two groups： 16 cases in experimental group （aorta crossclamped and mild hypothermia） and 14 cases in control group （aorta unclamped and moderate hypothermia）. Samples of right atrial myocytes were respectively taken before CPB and while intubatton in superior vena cava was taken off. The expression of atrial myocytes HSP70 was analyzed by Western blot. Results Atrial myocytes HSP70 expression in experimental group was （163.59 ±6.35 ）μg/ml before CPB, and （196.34 ± 4.23 ）μg/ml after CPB （P 〈0.01）,while HSPT0 expression in control group was （160.23 ±7.12）μg/ml before CPB,and （165.25 ±6.29）μg/ml after CPB （P 〉 0.05）. Whereas atrial myocytes HSP70 expression in experimental group was higher than that in control group after CPB （P 〈 0.05）. Conclusion Atrial myocytes HSP70 expression of atrial myocytes in beating heart MVR is higher than that in stop-beating heart MVR, which indicates operation on beating heart may place a premium on higher atrial myocytes HSP70 expression for protecting atrial myocytes and also proves myocytes ischemia and reperfusion injury from operation in beating heart is less than that in traditional stop-beating heart.

关 键 词：HSP70热休克蛋白质类 肌细胞 心脏 瓣膜置换术 心内直视手术 

分 类 号：R654.2[医药卫生—外科学]