心房颤动患者心房组织成纤维细胞增殖与心房纤维化的关系  

Relationship between atrial fibroblast proliferation/fibrosis and atrial fibrillation in patients with rheumatic heart disease

作　　者：林亚洲[1] 蔡金明[2] 陈林[1] 杨志平[1] 张建成[1] 吴卫[1] 柯丹[3] 许春萱[1] 

机构地区：[1]福建省立医院福建省心血管病研究所心内科,福州350001 [2]福建省莆田学院附属医院心内科 [3]武警福建总队医院心内科

出　　处：《中华心血管病杂志》2009年第9期813-817,共5页Chinese Journal of Cardiology

基　　金：福建省科技厅青年科技人才创新项目（2005J067）

摘　　要：目的检测碱性成纤维细胞生长因子（bFGF）、α平滑肌肌动蛋白（α-SMA）和增殖细胞核抗原（PCNA）在心房颤动（房颤）患者心房组织中的基因表达，探讨成纤维细胞增殖与心房纤维化关系的分子机制。方法75例风湿性心脏瓣膜病接受换瓣手术者分为三组，窦性心律组34例，阵发性房颤组11例，持续性房颤组30例；于术中获取右心耳组织，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和免疫组化技术测定bFGF、α-SMA和PCNA的mRNA和蛋白含量。结果阵发性房颤组、持续性房颤组心房组织胶原容积分数（CVF）明显高于窦性心律组（均为P〈0．01）；持续性房颤组增加更明显（P〈0．01）。心房组织CVF与左心房内径（r=0．320，P=0．005）、房颤持续时间呈正相关（r=0．390，P=0．010）。与窦性心律组相比，bFGF、α-SMA和PCNA的mRNA和蛋白表达水平在阵发性房颤患者（均为P〈0．05）、持续性房颤患者（P〈0．01）中均显著上调，持续性房颤组相对于阵发性房颤组亦明显增高（P〈0．05～0．01）。同时bFGF的mRNA和蛋白表达与CVF（r=0．330，P=0．004和r=0．292，P=0．013）、房颤持续时间（r=0．330，P=0．005和r=0．299，P=0．010）及左心房内径（r=0．342，P=0．003和r=0．285，P=0．015）呈正相关。结论心房组织中bFGF、α—SMA和PCNA的基因表达上调可能是成纤维细胞增殖导致心房纤维化的分子机制之一，与房颤的发生和维持有关。Objective To investigate the association between gene expressions of basic fibroblast growth factor（ bFGF）, smooth muscle alpha-actin （α-SMA） and proliferating cell nuclear antigen（PCNA） and atrial fibrosis in patients with atrial fibrillation （AF）. Methods The right atrial tissue samples were taken from 75 patients with rheumatic heart disease underwent heart valve replacement surgery （34 patients with sinus rhythm, 11 patients with paroxysmal AF and 30 patients with persistent AF） and stained with picrosirius red for quantitative analysis of collagen accumulation. The mRNA and protein levels of bFGF, α- SMA and PCNA were detected by semi-quantitative reverse transcription polymerase chain reaction （RT- PCR） and immunohistochemical technique, respectively. Results The percent volume fraction of collagen （CVF） was the highest in persistent AF group and the lowest in the sinus rhythm group（ all P 〈 0. 01 ）. CVF significantly correlated with AF duration （r =0. 390,P =0. 010） and left atria （LA） dimension（r =0. 320, P = 0. 005）. The mRNA and protein levels of bFGF, α-SMA and PCNA were significantly higher in the persistent AF group than those in the paroxysmal AF group （ all P 〈 0. 05 ） and significantly higher in both AF groups than those in the sinus rhythm group （ P 〈 0. 05-0. 01 ）. The mRNA and protein levels of bFGF were positively correlated with CVF（r = 0. 330, P = 0. 004 and r = 0. 292, P = 0. 013, respectively）, AF duration （ r = 0. 330, P = 0. 005 and r = 0. 299, P= 0. 010, respectively） and left atrial dimension （ r = 0. 342, P = 0. 003 and r = 0. 285, P = 0. 015, respectively）. Conelusion The increased gene expressions of bFGF, α-SMA and PCNA in atrium during AF may contribute to atrial fibrosis by promoting fibroblast proliferation in AF patients.

关 键 词：心房颤动 心房 纤维化 成纤维细胞生长因子2 

分 类 号：R686[医药卫生—骨科学]