风湿性心脏病心房颤动患者心房组织肝细胞生长因子结缔组织生长因子与转化生长因子β1基因表达的研究  

Change of gene expression of hepatocyte growth factor, connective tissue growth factor and trans forming growth factor-beta 1 in human atrium during atrial fibrillation

作　　者：李宏松[1] 陈颖敏[1] 李洪波[1] 徐瑾[1] 刘建平[1] 

机构地区：[1]上海交通大学医学院附属仁济医院心血管内科,200001

出　　处：《中华风湿病学杂志》2009年第8期549-552,共4页Chinese Journal of Rheumatology

基　　金：上海交通大学医学院自然科学研究基金（05HX21010）

摘　　要：目的观察风湿性心脏病心房颤动患者心房组织中肝细胞生长因子（HGF）、结缔组织生长因子（CTGF）、转化生长因子（TGF）-β1基因表达的变化。方法35例行心脏手术者于术中获取的右心耳（约200mg）分为3组，风湿性心脏病27例，其中窦性心律者8例，慢性持续性心房颤动者19例（≥6个月），分别列为风湿性心脏病窦性心律组和风湿性心脏病心房颤动组，另先天性心脏病患者8例（均为窦性心律）作为对照组，以β-肌动蛋白为内参照基因，通过实时荧光定量聚合酶链反应（real time PCR）技术，测定各组心房组织中HGF、CTGF、TGF-β1与Ⅰ型和Ⅲ型胶原mRNA的含量，苏木素-伊红（HE）和Masson病理染色观察右心耳组织纤维化程度。结果与对照组比较，CTGF、TGF-β1、Ⅰ型胶原、Ⅲ型胶原mRNA表达在风湿性心脏病窦性心律组和风湿性心脏病心房颤动组均显著增加（P〈0．05），且风湿性心脏病心房颤动组与风湿性心脏病窦性心律组比较也明显增加（P〈0．05）；HGF在风湿性心脏病窦性心律组较对照组增加，但比较差异无统计学意义，而在风湿性心脏病心房颤动组HGF下降明显，与对照组和风湿性心脏病窦性心律组比较差异均有统计学意义（P〈0．05）；相关性分析显示风湿性心脏病心房颤动患者心房组织Ⅰ型胶原、Ⅲ型胶原、TGF-β1和CTGF的mRNA表达与左房直径和组织纤维化面积有相关性。结论风湿性心脏病患者Ⅰ型胶原和Ⅲ型胶原mRNA表达增加，CTGF、TGF-β1 mRNA表达上调。具有抗纤维化作用的HGF mRNA表达在心房颤动时下降，可能是使得风湿性心脏病患者心房颤动易于发生和维持的重要原因。Objective The purpose of this study is to determine whether atrial expression of hepatoeyte growth factor （HGF）, connective tissue growth factor （CTGF） and transforming growth faetor-beta- 1 （TGF-β1） is altered in patients with rheumatic heart disease （RHD） and chronic atrial fibrillation （AF）. Methods Atrial tissue was obtained from the right atrial appendage during heart surgery from 35 patients. In 27 patients with rheumatic heart disease, 8 patients had no history of AF, and 19 had chronic persistent AF （ ≥ 6 months cAF）. Other 8 patients with congenital heart disease had no history of AF were the control group. The mRNA expression of HGF, CTGF, TGF-β1, collagen Ⅰand collagen Ⅲ was measured by the real-time fluorescence quota polymerase chain reaction （real time PCR）. The fibrosis of right atrial appendage was detected by HE and Masson staining. Results The amount of CTGF, TGF-β1, collagen Ⅰ and collagen Ⅲ was significantly increased in patients with sinus rhythm compared with the control group （P〈0.05） and further increased in patients with chronic AF compared with patients with sinus rhythm （P〈0.05）. The amount of HGF was significantly decreased in patients with chronic AF compared with patients with sinus rhythm and the control group （P〈0.05）. But the difference of the latter two groups was not statistically significant. Correlation analysis demonstrated that the mRNA expression of collagen Ⅰ , collagen Ⅲ, TGF-β1 and CTGF in right atrial appendage of RHD and AF was positively correlated with the left atrial diameter and the area of myocardial fibrosis. Conclusion In human atrium with RHD, the mRNA expression of collagen Ⅰ , collagen Ⅲ, CTGF and TGF-β1 is up-regulated. HGF has anti-fibrosis function and the down-regulation of its mRNA expression in patients with RHD may be an important factor in the initiation or maintenance of AF.

关 键 词：心房颤动 肝细胞生长因子 转化生长因子Β 胶原 结缔组织生长因子 

分 类 号：R686[医药卫生—骨科学]