TGF-β1在二尖瓣腱索断裂患者血清与组织中的表达  

Expression of TGF-β1 in serum and tissues of patients with mitral chordae tendineae rupture

作　　者：李跞 周景昕 赵萌 唐义虎 戴亚伟 吴延虎 LI Luo;ZHOU Jingxin;ZHAO Meng;TANG Yihu;DAI Yawei;WU Yanhu(Department of Cardiovascular Surgery,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院心脏大血管外科,江苏南京210029

出　　处：《南京医科大学学报（自然科学版）》2021年第7期1028-1032,1062,共6页Journal of Nanjing Medical University(Natural Sciences)

基　　金：国家自然科学基金(81700340)。

摘　　要：目的:探究人转化生长因子β1(transforming growth factorβ1,TGF-β1)在二尖瓣腱索断裂患者血清和组织中的表达,为进一步明确TGF-β1对于二尖瓣腱索病变的促进作用提供依据。方法:选取2020年5—12月南京医科大学第一附属医院收治的二尖瓣腱索断裂患者20例作为实验组,另选取同期健康体检者作为对照组。采用ELISA试剂盒检测血清TGF-β1水平,比较两组实验室检查及心脏彩超结果。同时,收取实验组断裂的二尖瓣腱索以及同期8例心脏移植受者正常二尖瓣腱索组织进行免疫组化染色和扫描电镜分析。结果:实验组患者血清TGF-β1水平高于对照组(P<0.05);实验组心脏彩超左房内径、左室舒张末期内径高于对照组(P<0.01);免疫组化染色显示TGF-β1、α-平滑肌动蛋白在断裂的二尖瓣腱索组织中呈高表达;扫描电镜显示断裂腱索组织镜下结构胶原纤维束排列紊乱,疏松层(外层)明显增厚、分层和断端,致密层(内层)可见有明显裂隙。结论:TGF-β1在二尖瓣腱索断裂患者的血清和腱索组织中呈高表达,提示其可能与二尖瓣腱索断裂的发生及发展有密切关系。Objective:To investigate the expression of transforming growth factor β1(TGF-β1)in serum and chordae tendineae tissue of patients with mitral valve chordae tendineae rupture,and to provide a basis for further understanding the promoting effect of TGF-β1 on mitral valve chordae tendineae lesion. Methods:20 patients with mitral chordae tendineae rupture admitted to the First Affiliated Hospital of Nanjing Medical University from May 2020 to December 2020 were selected as experimental group,and healthy examinees of the corresponding period were selected as normal group. Serum TGF-β1,clinical laboratory data and cardiac ultrasound data of all subjects were analyzed. Meanwhile,the ruptured mitral valve chordae in the experimental group and normal mitral tendinous chordae from 8 heart transplant recipients were collected during operation for immunohistochemical and electron microscope analysis.Results:The level of serum TGF-β1 in experimental group was significantly higher than that in control group(P < 0.05). The left atrial diameter(LAD)and left ventricular end diastolic diameter(LVEDd)in the experimental group were significantly higher than those in the control group(P < 0.01). Immunohistochemistry showed high expression of TGF-β1 and α-smooth muscle actin(α-SMA)in the ruptured chordae tendineae tissues. Scanning electron microscopy showed disordered arrangement of collagen fiber bundles in the ruptured chordae tendineae tissues. The loose layer(outer layer)was obviously thickened,stratified and broken end,and the dense layer(inner layer)had obvious cracks. Conclusion:TGF-β1 is highly expressed in the serum and ruptured chordae tendineae tissues of patients with mitral chordae tendineae rupture. It is suggested that it may be closely related to the occurrence and development of mitral chordae tendineae rupture.

关 键 词：二尖瓣腱索断裂 TGF-Β1 纤维化 

分 类 号：R654.2[医药卫生—外科学]