α-SMA与瓣膜性心房颤动患者心房纤维化的关系  

Relationship between α-SMA and atrial fibrosis in patients with valvular atrial fibrillation

作　　者：潘军强[1] 张殿新[2] 孙超峰[3] 杨进[1] 

机构地区：[1]西北大学生命科学学院预防基因组医学研究所,陕西西安710069 [2]第四军医大学附属西京医院心血管内科,陕西西安710032 [3]西安交通大学第一附属医院心血管内科,陕西西安710061

出　　处：《西安交通大学学报（医学版）》2017年第2期242-246,共5页Journal of Xi’an Jiaotong University（Medical Sciences）

基　　金：国家自然科学基金资助项目(No.81270236)~~

摘　　要：目的研究α-SMA在瓣膜性心房颤动(AF)患者心房组织中的表达及其与心房纤维化的关系。方法选择因风湿性心脏瓣膜病住院并行瓣膜置换手术的患者84例(AF组39例、窦性心律组45例),收集整理患者的临床资料,并于手术中获取右心房组织(0.3~0.5cm3)。Masson染色观察两组患者右心房纤维化程度;Western blot及RTqPCR技术测定心房组织中α-SMA蛋白及mRNA的表达,相关分析探讨α-SMA与心房纤维化的关系。结果两组患者的性别构成比、年龄、血压、血常规、生化指标等差异无统计学意义(P>0.05),AF组左、右心房直径明显大于窦性心律组(P<0.05);Masson染色结果提示,AF组心房组织存在明显纤维化,且胶原容积分数与胶原含量显著高于窦性心律组(P<0.05);AF组患者心房组织α-SMA的mRNA及蛋白表达均显著高于窦性心律组(P<0.05);84例患者右心房组织中α-SMA的mRNA及蛋白表达量均与胶原含量呈正相关(相关系数分别为0.587、0.607;P值分别为0.029、0.014)。结论瓣膜性AF患者心房组织存在明显的心房纤维化,与α-SMA基因转录水平上调密切相关。Objective To investigate the expression ofα-smooth muscle actin（α-SMA）in patients with valvular atrial fibrillation and study the relationship betweenα-SMA and atrial fibrosis in patients with valvular atrial fibrillation（AF）.Methods For this study we enrolled 84 consecutive patients with rheumatic heart disease who were to receive cardiac surgery.The patients were divided into AF group（AF,n=39）and sinus rhythm group（SR,n=45）.Their clinical data including baseline demographics,routine laboratory test and echocardiographics were collected before surgery.The right atrial tissue（0.3-0.5cm3）was disserted during the surgery.Right atrial fibrosis was observed by Masson staining.The mRNA expression ofα-SMA in atrial tissue were determined by Real-time quantitative PCR.Western blot was used to measure the protein expression ofα-SMA in atrial tissue.Results The two groups did not significantly differ in sex ratio,age,blood pressure,blood biochemical indicators or other aspects of medical history（P〉0.05）.However,left and right atrium diameters in AF group were significantly larger than those in SR group（P〈0.05）.Masson staining suggested that collagen volume fraction and collagen content were significantly higher in AF group than in SR group（P〈0.05）.The mRNA and protein expressions ofα-SMA in right atrial tissue were obviously higher in AF group than in SR group（coefficients P〈0.05）.The mRNA and protein expressions ofα-SMA from right atrial tissue in the 84 patients were positively correlated with collagen content（coefficients of 0.587 and 0.607;P=0.029,0.014,respectively）.Conclusion There is significant atrial fibrosis in patients with valvular atrial fibrillation,which is closely related to up-regulated expression ofα-SMA gene.

关 键 词：风湿性心脏瓣膜病 心房颤动 心房纤维化 心房重塑 α-平滑肌肌动蛋白(α-SMA) 

分 类 号：R541.7[医药卫生—心血管疾病]