风湿性心脏病二尖瓣和主动脉瓣Ⅰ、Ⅲ型胶原重建的研究  

Collagen Ⅰ、Ⅲ remodeling in mitral and aortic valve of patients with rheumatic heart disease

作　　者：牛建立[1] 成杞润[1] 贾清仁[1] 田玉旺[2] 邓永江[2] 

机构地区：[1]北京军区总医院心血管外科,100700 [2]北京军区总医院病理科,100700

出　　处：《中华实验外科杂志》2002年第4期324-325,共2页Chinese Journal of Experimental Surgery

基　　金：国家自然科学基金资助项目 (39870 738)

摘　　要：目的　对风湿性心脏病二尖瓣、主动脉瓣胶原重建进行定性、定位、定量研究。方法手术切除风湿性二尖瓣和主动脉瓣组织各 3 0枚 ,尸检中取人正常二尖瓣和主动脉瓣组织各 5枚。应用免疫组织化学技术结合图像自动分析方法观察二尖瓣和主动脉瓣Ⅰ、Ⅲ型胶原分布及含量的变化。结果　正常二尖瓣组织Ⅰ、Ⅲ型胶原分别为 11.78± 0 .86、8.72± 0 .64 ,明显高于主动脉瓣组织 (9.5 6± 0 .3 2、6.82± 0 .3 4) (P <0 .0 5 ) ,二尖瓣Ⅰ /Ⅲ胶原比值 (1.3 6± 0 .0 6)低于主动脉瓣(1.42± 0 .0 8) (P <0 .0 5 ) ;风湿性病变时 ,二尖瓣和主动脉瓣Ⅰ、Ⅲ型胶原含量及Ⅰ /Ⅲ比值均增加 ,分别为 (2 2 .3 2± 2 .82、10 .76± 1.0 8、2 .0 6± 0 .12 )和 (16.86± 2 .3 6、9.12± 1.76、1.86± 0 .3 2 ) ,以Ⅰ型胶原为主 ,明显高于正常对照组 (P <0 .0 5 )。结论　风湿性二尖瓣和主动脉瓣胶原重建以Ⅰ型胶原增加为主 ,呈修复性纤维化改变。Objective To study the distribution,location and quantity of collagen in mitral and aortic valve of patients with rheumatic heart disease.Methods 30 samples of mitral and aortic valve were obtained from patients undergoing surgical valve replacement,and 5 samples of human normal mitral and aortic valve from autopsy.The method of immunohistochemical technique combined with automatic image analysis was used to investigate the changes of collagen typeⅠand Ⅲ.Results Contents of collagen typeⅠand Ⅲ in normal mitral and aortic valve were (11.78±0.86),(8.72±0.64),(9.56±0.32),(6.82±0.34),and the ratio of Ⅰ/Ⅲ were (1.36±0.06) and (1.42±0.08,P<0.05),respectively.Contents of collagen typeⅠ,Ⅲ and the ratio of Ⅰ/Ⅲ were all significantly increased in rheumatic mitral and aortic valve(22.32±2.82),(10.76±1.08),(2.06±0.12),(16.86±2.36),(9.12±1.76),(1.86±0.32)(P<0.05 vs controls)respectively,and the increase of collagen typeⅠwas dominant.Conclusion The collagen remodeling in rheumatic mitral and aortic valve are reparative fibrosis due to dominant increase of collagen typeⅠ.

关 键 词：风湿性心脏病 二尖瓣 主动脉瓣 重建 I型胶原 Ⅲ型胶原 

分 类 号：R541.2[医药卫生—心血管疾病]