失神经支配环杓后肌形态及半胱氨酸天冬氨酸蛋白酶-3表达的研究  

Morphological Alteration and the Protein Expression of Caspase-3 in Denervated Posterior Cricoarytenoid Muscles

作　　者：张贤[1] 王茂鑫[1] 

机构地区：[1]南京军区福州总医院耳鼻咽喉科,南京350025

出　　处：《听力学及言语疾病杂志》2015年第5期489-492,共4页Journal of Audiology and Speech Pathology

摘　　要：目的：探讨长期失神经支配环杓后肌形态学及半胱氨酸天冬氨酸蛋白酶－3（Caspase－3）表达水平的变化，为晚期喉神经修复选择时限提供参考。方法45例不同时间喉返神经损伤患者的环杓后肌标本按神经损伤时间分为3组：3～6个月（18例）、7～12个月（15例）、13～24个月（12例）；取行喉全切除术喉癌患者未受肿瘤侵犯侧的正常环杓后肌标本作为正常对照组（12例），各组标本均通过 H E染色观察肌肉形态，通过免疫组化染色、Western blot观察环杓后肌Caspase－3表达的变化趋势。结果随着失神经时间的延长，环杓后肌肌纤维细胞有不同程度的变性，肌细胞核内移、集中，呈串珠状排列。失神经各组Caspase－3在肌细胞核均有表达，3～6个月组表达量最高，其他各组逐渐下降，而对照组基本无表达。Western blot结果显示，对照组、失神经3～6个月、7～12个月、13～24个月组Caspase－3的相对表达量分别为1．30±0．03、20．78±0．11、11．33±0．43、3．14±0．17，失神经3～6个月组为对照组的21倍，7～12个月组为对照组的11倍，13～24个月组为对照组的3倍。结论失神经支配1年内是喉肌凋亡较严重时期，以后凋亡速度减慢，喉神经修复应尽量在1年内进行。Objective To investigate the morphological alteration and the protein expression of caspase -3 in long -term denervated posterior cricoarytenoid muscles （PCAMs）in order to find the appropriate time point of rein‐neration in long -term denervated PCAMs .Methods A total of 45 patients with vocal paralysis were recruited and devided into 3 groups ,the 3~6 months denervation group ,the 6~12 months denervation group ,the 1~2 year denervation group .12 adults served as control group .The morphological alteration was evaluated using HE staining and the change in expression of caspase -3 ,an apoptosis related factor ,were observed using immunehistochemistry stain and western blot .Results With elongation of denervation time ,there were increased denaturation in the mus‐cle fibers .The nucleus moved inside and some of them concentrated .Caspase-3 showed weak staining in innerva‐ted ,however ,by 3-6 months of muscle denervation there was a significant accumulation of caspase -3 protein in myofibers ,6~12 months and 1~2 years of denervation ,expression of caspase -3 protein in myofibers was de‐creased significantly .In western blot ,the change in protein expression of caspase -3 was observed an 21-fold （P〈 0 .01） increase from 3~6 months denervated muscles to innervated muscles ,11-fold （P〈 0 .01） increase from 6~12 months denervated muscles to innervated muscles ,3~fold （P〈 0 .01） increase from 1~2 year denervated muscles to innervated muscles .Conclusion The morphological alterations and changes in expression of caspase -3＆nbsp;indicated there was a high amplitude of apoptosis in denervated posterior cricoarytenoid muscles within 1 year .

关 键 词：半胱氨酸天冬氨酸蛋白酶-3 失神经支配 环杓后肌 凋亡 

分 类 号：R767.6[医药卫生—耳鼻咽喉科]