瓣膜病患者钙调神经磷酸酶-活化T细胞核因子通路与心房纤颤的关系  

Association between calcineurin-nuclear factor of activated T cell pathway and atrial fibrillation in patients with valvular heart disease

作　　者：李丛[1] 王建春[1] 赵勇[1] 邹承伟[2] 孙慧[3] 张庆[1] 

机构地区：[1]山东大学附属省立医院保健心血管科,山东济南250021 [2]山东大学附属省立医院心外科,山东济南250021 [3]山东大学附属济南市中心医院心内科,山东济南250013

出　　处：《山东大学学报（医学版）》2014年第8期47-51,共5页Journal of Shandong University:Health Sciences

基　　金：山东省科技发展计划(2013G0021819);山东省自然科学基金(ZR2011HM072;ZR2010HQ048);山东省医药卫生科技发展计划(2011BJZD05);国家自然科学青年基金(30900608);济南市青年科技明星计划(20080112)

摘　　要：目的探讨瓣膜病患者钙调神经磷酸酶-活化T细胞核因子通路(CaN-NFAT通路)与心房纤颤的关系。方法选择因瓣膜病接受换瓣手术治疗患者43例,根据心律状况分为慢性持续性房颤组(n=24)和窦性心律组(n=19),术前抽取外周静脉血,术中取右心耳心肌组织。在查体中心抽取20例健康查体者的静脉血标本为健康对照组。以β-actin为内参照,采用RT-PCR法分别检测房颤组和窦性心律组外周血淋巴细胞及心肌组织中的CaN催化亚基(CnA)的α(CnAα)、β(CnAβ)异构体、NFATc3、NFATc4的mRNA水平,健康对照组外周血淋巴细胞中的CnAα、CnAβ、NFATc3和NFATc4的mRNA水平。结果与窦性心律组和健康对照组相比,房颤组外周血淋巴细胞中CnAα、CnAβ、NFATc3的mRNA水平升高(P<0.05)。与窦性心律组相比,房颤组心肌细胞中的CnAα、CnAβ、NFATc3和NFATc4的mRNA水平升高(P<0.05)。结论钙调神经磷酸酶-活化T细胞核因子通路可能与瓣膜病患者心房纤颤有关。Objective To explore the association between calcineurin-nuclear factor of activated T cell pathway（ CaN-NFAT pathway） and atrial fibrillation（ AF） in patients with valvular heart disease（ VHD）. Methods A total of 43 patients with VHD who underwent valve replacement surgery were enrolled,including 24 with chronic persistent AF and 19 with sinus rhythm（ SR）. Peripheral venous blood samples were taken before surgery and cardiac muscle tissues were taken from the right atrial appendages during surgery. Blood samples were also collected from 20 healthy controls. Transcription of α- and β- isoforms of CaN subunit A（ CnA） and NFATc3,NFATc4 in peripheral lymphocytes and right atrial appendages were assessed by real-time reverse transcription polymerase chain reaction（ RT-PCR）,with β-actin as an internal reference. Results Compared with SR patients and healthy controls,the mRNA levels ofCnA α-isoform,CnA β-isoform and NFATc3 were elevated in peripheral lymphocytes from AF patients（ P〈0. 05）.Compared with SR patients,the mRNA levels of CnA α-isoform,CnA β-isoform,NFATc3 and NFATc4 were elevated in cardiac tissues from AF patients（ P〈0. 05）. Conclusion CaN-NFAT pathway is associated with AF in patients with VHD.

关 键 词：房颤 瓣膜病 钙调神经磷酸酶 活化T细胞核因子 MRNA 

分 类 号：R541.7[医药卫生—心血管疾病]