晚期扩张型心肌病患者心肌Cx43蛋白表达的研究  

Myocardial connexin 43 expression in the patients with refractory dilated cardiomyopathy

作　　者：陈新山[1] 郭晖[2] 刘念[3] 闫杰[1] 张益鹄[1] 

机构地区：[1]华中科技大学同济医学院病理学教研室,武汉430030 [2]华中科技大学同济医学院附属同济医院器官移植研究所 [3]华中科技大学同济医学院附属同济医院心内科

出　　处：《临床心血管病杂志》2010年第5期349-352,共4页Journal of Clinical Cardiology

基　　金：湖北省科技攻关计划资助项目(No:2007AA301B31-3);武汉市科技攻关计划项目(No:201060623254)

摘　　要：目的:探讨晚期扩张型心肌病(DCM)患者心肌连接蛋白43(Cx43)表达变化及其意义。方法:运用免疫组化和图像分析技术,对5例晚期DCM患者和4例因其他心脏疾病(A对照组)行心脏移植手术切除的心脏及4例机械性损伤死者(B对照组)的左心室心肌Cx43蛋白表达进行定位和定量研究。结果:DCM患者心肌Cx43蛋白表达较清晰,主要位于心肌闰盘处,呈条状、斑点或颗粒状散在分布,有的散在分布于心肌细胞侧边;A对照组表达清楚,位于心肌闰盘处,主要呈条状,少数呈斑点状散在分布,而心肌侧边分布很少;B对照组阳性着色较淡,在闰盘处呈条状分布,少有斑点状散在分布,心肌侧边几无表达。定量检测和统计分析发现,DCM组心肌Cx43蛋白表达的量低于A对照组但高于B对照组。心肌Cx43蛋白表达的平均光密度,DCM组与A对照组、B对照组相比,A对照组与B对照组相比,差异均有统计学意义(P<0.01);心肌Cx43蛋白表达的S值,DCM组、A对照组、B对照组间比较,差异均无统计学意义(P>0.05)。结论:晚期DCM患者心肌Cx43蛋白表达的数量和分布均发生改变,这种变化很可能是导致DCM患者发生心律失常和心功能衰竭的病理基础。Objective：To explore change of myocardial connexin43（Cx43） expression in the patients with refractory dilated cardiomyopathy（DCM）.Method：Immunohistochemiscal and image analytic techniques were used to investigate myocardial Cx43 expression in the left ventricular wall of 5 patients with severe DCM and 4 patients with other cardiac diseases（control group A） whose hearts were transplanted in Tongji hospital and 4 cases（control group B） who died of violent causes during the same time.Result：Myocardial Cx43 expression in group of DCM patients was clearly observed and mainly located in the intercalated disc（ID） in the form of strip,some of them,spots or particles,which located in the side of myocardia as well.It was observed more clearly in the control group A than DCM group,which located mainly in ID in the form of strip,only a few scattered in the form of spots or particles,but a few expression was also seen in the side of myocardia.The myocardial Cx43 expression was weak in the control group B which located mainly in ID in the form of strip,but without spots or particles,and no expression was seen in the side of myocardia.The result of statistical analysis： About average optical density（A value） of myocardial Cx43 expression,there are very differences between DCM group and control group A,between DCM group and control group B,and between control group A and control group B.But there are no difference among DCM group,control group A and control group B about area（S value） of myocardial Cx43 expression.Conclusion：The quantity,form and distribution of Cx43 expression in myocardia changed in patients with refractory DCM.These changes maybe the pathological bases of arrhythmia and heart failure.

关 键 词：心肌病 扩张型 连接蛋白43 心脏移植 免疫组化 

分 类 号：R542.2[医药卫生—心血管疾病]