代谢综合征影响退行性主动脉瓣脂肪因子的表达  

Metabolic Syndrome Influences the Expression of Adipokines in Degenerative Aortic Valves

作　　者：谢霆[1] 李儒正[1] 张树华[2] 吴朝光[1] 张红[1] 董明[1] 谌绚 陈新忠[3] 

机构地区：[1]海南省人民医院心脏外科,海口570311 [2]华中科技大学同济医学院附属协和医院普外科,武汉430022 [3]华中科技大学同济医学院附属协和医院心血管外科,武汉430022

出　　处：《华中科技大学学报（医学版）》2016年第1期82-86,共5页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

基　　金：国家自然科学基金资助项目(No.81270265);海南省自然科学基金资助项目(No.814306);海南省卫生厅资助项目(No.琼卫2012-07)

摘　　要：目的研究脂肪因子在退行性主动脉瓣疾病(DAVD)患者血液和瓣膜标本中的表达特点。方法收集2012年9月至2015年9月在海南省人民医院心外科因退行性主动脉瓣病变行手术切除的严重钙化主动脉瓣标本和血液标本80例[男40例,女40例,年龄(61±6)岁],其中40例合并有代谢综合征(MS);以及因夹层动脉瘤或心脏移植进行手术切除的正常主动脉瓣标本8例[男6例,女2例,年龄(48±7)岁];健康成人志愿者血液标本40例[男20例,女20例,年龄(60±8)岁]。ELISA法检测chemerin、瘦素、脂联素的血浆浓度,经苏木精-伊红(HE)染色和免疫组织化学染色,观察退行性主动脉瓣的组织学改变和脂肪因子chemerin、瘦素、脂联素免疫组织化学染色的表达特点,RT-PCR检测组织中chemerin、瘦素基因的表达。结果 chemerin、瘦素血浆浓度在DAVD患者较成人健康志愿者升高,DAVD合并MS较DAVD不合并MS患者升高;脂联素血浆浓度在DAVD患者较成人健康志愿者降低,DAVD合并MS较DAVD不合并MS患者降低;与正常主动脉瓣比较,DAVD患者主动脉瓣增厚,结节性钙化灶周围存在脂肪样组织,HE染色发现在钙化灶周围有巨噬细胞和其它的炎症细胞、泡沫样细胞、脂肪样细胞、新生血管形成;免疫组织化学染色见正常主动脉瓣chemerin、瘦素、脂联素阴性表达,DAVD患者主动脉瓣脂联素阴性表达,然而可见chemerin和瘦素阳性表达,DAVD合并MS较DAVD不合并MS患者主动脉瓣中chemerin和瘦素表达增加;RT-PCR显示DAVD合并MS较DAVD不合并MS患者主动脉瓣chemerin和瘦素mRNA表达增高。结论退行性主动脉瓣存在脂肪因子chemerin和瘦素表达,代谢综合征影响退行性主动脉瓣脂肪因子chemerin和瘦素表达。Objective To investigate the expression of adipokines in the blood and aortic valve in patients with degenerative aortic valve disease（DAVD）.Methods The severely calcified aortic valve specimens and blood samples were collected from 80 patients who underwent heart surgery due to DAVD from Sep.2012 to Sep.2015 in Hainan Provincal People＇s Hospital.The patients consisted of 40 males and 40 females with the average age of（61±6）years old.Among them,40 patients were complicated with metabolic syndrome（MS）;8patients with dissecting aneurysm[6 males,2females,aged（48±7）years]had normal aortic valves.Blood samples were also harvested from healthy adult volunteers（n=40;including 20 males and 20 females,aged（60±8）years old）.Serum levels of chemerin,leptin,and adiponectin were detected by ELISA.The histological changes of degenerative aortic valves and the expressions of chemerin,leptin,and adiponectin were observed by HE staining and immunohistochemical staining,respectively.The expression levels of chemerin and leptin were also detected by RT-PCR.Results The plasma levels of chemerin and leptin were significantly increased in DAVD patients when compared with those in adult healthy volunteers and they were higher in DAVD patients with MS than in DAVD patients without MS.The plasma level of adiponectin was obviously reduced in DAVD patients relative to adult healthy volunteers,and it was much lower in DAVD patients with MS than in DAVA patients without MS.Compared with normal aortic valves,degenerative aortic valves became thickened,and fat-like tissue was around the calcified nodules.HE staining revealed that macrophages,other inflammatory cells,foam-like cells,fat-like cells,angiogenesis were observed surrounding the calcified nodules.Immunohistochemistry showed that the expressions of chemerin,leptin and adiponectin were absent in normal aortic valves.But in degenerative aortic valves,chemerin and leptin except adiponectin were positively expressed.The protein and mRNA expressions of chemerin

关 键 词：退行性主动脉瓣疾病 脂肪因子 CHEMERIN 瘦素 脂联素 

分 类 号：R322.1[医药卫生—人体解剖和组织胚胎学]