心房颤动患者心房组织肿瘤坏死因子-α的表达  

Changes of tumor necrosis factor-alpha in human atria during atrial fibrillation

作　　者：柯丹[1] 许春萱[2] 张建成[2] 曾国彬[1] 郑国龙[1] 曾建[1] 胡锡衷[2] 

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

出　　处：《中国心脏起搏与心电生理杂志》2008年第2期131-134,共4页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：目的观察肿瘤坏死因子-α(TNF-α)在心房颤动(简称房颤)患者心房组织中基因转录和蛋白表达的改变,探讨房颤患者心房结构重构的分子机制。方法75例风湿性心脏瓣膜病接受换瓣手术者分为三组,其中窦性心律组34例、阵发性房颤组11例、持续性房颤组30例,于术中取右心耳组织,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,分别采用半定量逆转录-聚合酶链反应技术和免疫印迹法测定TNF-α的mRNA含量和蛋白含量。结果①房颤组心房组织存在明显纤维化,纤维化程度与左房内径、房颤持续时间呈正相关(r=0.390,0.320,P均<0.05);②持续性房颤组心房组织中TNF-α的mRNA及蛋白水平较窦性心律组、阵发性房颤组明显增加(P<0.01)。TNF-α的mRNA水平与房颤持续时间呈正相关(r=0.298,P=0.01);蛋白表达水平与左房内径、房颤持续时间、胶原容积分数呈正相关(r分别为0.280,0.334,0.383,P均<0.05)。结论房颤患者心房组织中TNF-α的表达增加可能是引起房颤患者心房结构重构的分子机制之一。Objective To determine whether atrial expression of tumor necrosis factor-alpha（TNF-α） is altered in patients with atrial fibrillation （AF）. Methods The right atrial tissue samples were taken from 75 patients with rheumatic heart disease who underwent heart valve replacement surgeries. 34 patients were in sinus rhythm, 11 patients had paroxysmal AF and 30 patients had persistent AF. Picrosirius red staining was used for quantitative analysis of collagen accumulation. The mRNA and protein level of TNF-α were measured by semi-quantitative reverse transcription-polymerase chain reaction and western-blotting analysis respectively. Results ①Atrial fibrosis tissue content significantly increased in both paroxysmal AF and persistent AF groups than 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 was （CVF） significantly correlated with left atrial （LA） dimension and AF duration（ all P 〈 0.01 ）. ②TNF-α expression at mRNA and protein level increased more significantly in the persistent AF group than the paroxysmal AF group and the sinus rhythm group（P 〈0.05 ～0. 001 ）. The mRNA level of TNF-α was positively correlated with AF duration（P 〈0.05）. The protein level was positively correlated with LA dimension , AF duration and CVF （ all P 〈 0.05 ）. Conclutions The upregulation of TNF-α expression may have contributed to the atrial structure remodeling during AF.

关 键 词：心血管病学 心房颤动 肿瘤坏死因子 重构 

分 类 号：R541.75[医药卫生—心血管疾病]