心房颤动患者心房组织中的胶原重构  

Remodeling of atrial collagens in patients with atrial fibrillation

作　　者：柯丹[1] 许春萱[2] 曾国彬[1] 曾建[1] 胡锡衷[2] 

机构地区：[1]武警福建总队医院心内科,福州350003 [2]福建省心血管病研究所心内科,福州350001

出　　处：《武警医学》2008年第1期36-40,共5页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的研究风湿性心脏瓣膜病心房颤动(房颤)患者心房组织中胶原表达的变化,探讨房颤患者心房纤维化的机制及其在房颤发生、持续中的作用。方法75例风湿性心脏瓣膜病接受换瓣置换手术者分为3组,其中窦性心律组34例,阵发性房颤组11例,慢性房颤组30例,于术中获取右心耳组织约100mg,采用苦味酸天狼猩红染色法对心房组织胶原沉积量及分布情况进行分析,应用半定量反转录-聚合酶链反应(RT-PCR)方法,测定心房组织中Ⅰ型胶原、Ⅲ型胶原的mRNA水平。结果(1)房颤患者心房组织存在明显纤维化,纤维化程度与左心房内径(r=0.390,P=0.001)、房颤持续时间呈正相关(r=0.320,P=0.005);(2)与窦性心律组比较,Ⅰ型胶原的mRNA在阵发性房颤患者(P<0.05)、慢性房颤患者(P<0.001)心房组织中的表达均明显增加;房颤患者Ⅲ型胶原的mRNA表达虽有增加,但差异无统计学意义。Ⅰ型胶原的mRNA表达水平与左心房内径(r=0.336,P=0.004)、房颤持续时间(r=0.339,P=0.003)呈正相关。结论房颤患者心房组织存在明显纤维化,Ⅰ型胶原的分子重构可能是房颤时心房纤维化发生的分子机制之一,与房颤的发生和持续有关。Objective To determine whether the expression of atrial collagens is altered in patients with atrial fibrillation （AF） and to investigate their effects on the initiation and maintenance of AF. Methods Right atrial tissue samples were taken from 73 patients with rheumatic heart disease who underwent heart valve replacement surgery. Thirty - four patients had no history of AF, 9 patients had paroxysmal AF, and 30 patients had chronic AF. Picrosirius red staining was used for quantitative analysis of collagen accumulation. The mRNA content of collagens type Ⅰ and Ⅲ was measured by senti - quantitative reverse transcription - polymerase chain reaction （RT- PCR）. Results （1） Atrial fibrosis tissue content significantly increased in both the paroxysmal AF and persistent AF groups, compared with that in the sinus rhythm group （ all, P 〈 0. 001 ） ; the significant difference was also observed between the persistent AF and paroxysmal AF groups （ P 〈 0.01 ）. Collagen volume fraction（CVF） significantly correlated with left atria（LA） dimension and AF duration（all, P 〈0.01）. （2） The mRNA of collagen type Ⅰ increased significantly in the chronic AF group （ P 〈0.001）,followed by the paroxysmal AF group （ P 〈0.05）,compared with the sinus rhythm group.The mRNA of collagen type Ⅲ was slightly higher in both AF groups than that in the sinus rhythm group, but the differences were not statistically significant （ P 〉 0.05）. The mRNA of collagen type Ⅰ was significantly correlated with left atrial dimension （r= 0.336, P = 0.004） and AF duration （r= 0.339, P = 0.003） .Condutions The increased level of collagen type Ⅰ in atrium aright be one of the molecular mechanisms of atrial fibrosis during atrial fibrillation, which correlates with the initiation and maintenance of AF.

关 键 词：心房颤动 胶原 重构 

分 类 号：R331.3[医药卫生—人体生理学]