老年急性心肌梗死猝死者心肌细胞凋亡的研究  

Study myocyte apoptosis in sudden death with acute myocardial infarction

作　　者：马中富[1] 马虹[2] 叶任高[2] 罗斌[3] 朱全胜[3] 吴金浪[3] 

机构地区：[1]中山医科大学附属第一医院急诊科,广东广州510080 [2]中山医科大学附属第一医院内科 [3]中山医科大学基础学院

出　　处：《中国老年学杂志》2001年第1期6-9,共4页Chinese Journal of Gerontology

基　　金：卫生部基金资助!(96- 1 - 1 1 6)

摘　　要：目的　探讨细胞凋亡在老年急性心肌梗死 (AMI)时心肌细胞中的意义。方法　用末端原位标记 (TUNEL )法、DNA电泳和电镜三种方法检测老年 AMI猝死者和心脏正常的车祸死亡者心肌细胞的凋亡。结果　 TUNEL法发现 ,猝死者梗死区的心肌细胞凋亡千分数老年组 (663.0 0‰± 1 1 7.1 2‰ )明显高于正常对照 (34.30‰± 2 0 .68‰ ) (P<0 .0 0 1 ) ;心肌细胞凋亡千分数在冠脉 1支病变者(51 4 .2 8‰± 1 65.1 2‰ ) <2支病变者 (564.38‰± 1 0 2 .1 2‰ ) <3支病变者 (668.2 5‰± 1 2 7.1 9‰ ) ,虽然均明显高于正常对照 (均 P<0 .0 1 ) ,但三组之间比较则无统计学上的差别 (均 P>0 .0 5) ;冠脉 2～ 3支病变者梗死区的心肌细胞 DNA电泳可见相差约 1 80～ 2 2 0 bp的阶梯片段 ;电镜发现猝死者梗死区内的心肌细胞核膜完整、染色质浓集、电子密度增加的凋亡特征 ,有的则出现核膜破裂、染色质溶解成碎屑的坏死现象。结论　细胞凋亡在老年Objective To explore the significances of myocyte apoptosis in elderly patients with acute myocardial infarction(AMI).Methods Myocyte apoptosis in elder patients with sudden death caused by AMI and normal controls died in traffic accident was studied by TdT Mediated dUTP Nick End Labing(TUNEL),DNA laddering on agarose gel electrophoresis and electron microscope.Results (1)The permillage of myocyte apoptosis in infarct area in elder patients with sudden death caused by AMI was significantly higher than that in control group(663 00‰±117 12‰ vs 34 30‰±20 68‰, P <0 01).However the permillage of myocyte apoptosis in 1 vessel,2 vessel,and 3 vessel disease were 514 28±165 12‰,564 38‰±102 33‰ and 668 25‰±127 19‰,respectiverly,significantly higher as compared to control group(All P <0 01).But no significance was found among the three groups.(2)The size of DNA fragment about 180～200 bp was found only in those patients with two and three vessels involoved.(3)The electron microscope showed the characteristics of myocyte apoptosis episodes,the others showed the characteristics of necrosis.Conclusions Myocyte apoptosis may play a key role in the process of myocyte death in infarct area in elder patients with sudden death caused by AMI.

关 键 词：细胞凋亡 急性心肌梗死 猝死 老年人 

分 类 号：R542.22[医药卫生—心血管疾病] R329.25[医药卫生—内科学]