风湿性心脏病心肌中增殖细胞核抗原和α-平滑肌肌动蛋白的表达与心功能关系

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1、风湿性心脏病心肌中增殖细胞核抗原和α-平滑肌肌动蛋白的表达与心功能关系风湿性心脏病心肌中增殖细胞核抗原和α-平滑肌肌动蛋白的表达与心功能关系2010-09-07张近宝　刘维永　晏培松　王剑波　岳瑾琢　朱霆　　【摘要】　目的　阐明慢性风湿性心脏病(风心病)心肌中增殖细胞核抗原（PCNA）、α-平滑肌肌动蛋白（α-SMA）阳性表达的意义及与心功能的关系。方法　用PCNA、α-SMA单克隆抗体对风心病二尖瓣病变心肌组织进行免疫组化及免疫电镜观察，图像分析仪定量分析其阳性表达率、心肌纤维化面积、微动脉内外径比值,并与左室心功能对比。结果　发现风心病心肌间质纤维化和微动脉

2、管壁增厚,管腔变窄。PCNA在风心病肥大心肌细胞和间质细胞核中均有表达、α-SMA在风心病心肌间质细胞中有表达，后者多位于血管周边。结论　（1）风心病心肌细胞表型发生改变,PCNA的阳性表达率与心肌纤维化面积成正比；（2）间质细胞不仅参与了心肌间质纤维化,且在血管改建中起重要作用；（3）PCNA阳性表达程度及心肌纤维化面积与左心功能成负相关。　　【关键词】　风湿性心脏病　　增殖细胞核抗原　　肌动蛋白类　　心室功能StudyoftherelationshipbetweenexpressionofPCNA,α-SMAandleftventriclecardiacfu

3、nctioninmyocardiumofthepatientswithrheumaticheartdisease　　ZhangJinbao,LiuWeiyong,YanPeisong,etal.XijingHospitalFourthMilitaryMedicalUniversity,PLA,Xi'an,710032　　【Abstract】　Objective　TorevealthesignificanceofpositiveexpressionofPCNA,α-SMAandtherelationshipbetweenthatandleftventricular

4、cardiacfunctioninmyocardiumofthepatientswithrheumaticheartdisease.Methods　ThepapillarymusclesamplesobtainedfromthepatientswithrheumaticheartdiseasewereimmunohistochemicallystainedwithmonoclonalantibodyofPCNA,α-SMAandobservedbyimmunoelectronmicroscopy.Ima-ginganalysiswasemployedtomeas

5、urethedegreeofimmunohistochemicalstaining,theareasofmyocardiumfibrosisandtheratiosbetweenarteriolarinnerandouterdiameter.Thedatawerecomparedwithcardiacfunction.Results　Interstitialfibrosisinrheumaticmyocardiumwassignificant.Thewallofsmallarteriesappearedthickandtuneappearednarrow.Imm

6、unohistochemicalPCNApositiveexpressionwasexhibitedinhypertrophiccardiomyocytesandinterstitialcellnuclei.α-SMApositiveexpressionwasininterstitialcellsofrheumaticmyocardium,andmostofthesecellsappearedaroundtheartery.Conclusion　(1)Thephenotypeofmyocardialcellhadaltered,therateofPCNAposi

7、tiveexpressionwasdirectlyproportionaltotheareasofmyocardiumfibrosis.(2)Interstitialcellsnotonlytakepartininterstitialfibrosisprogressbutalsoplayakeyroleinvascularreconstruction.(3)ThedegreeofPCNApositiveexpressionandtheareasofmyocardiumfibrosiswerenegativeassociatedwithcardiacfunctio

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