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风湿性心脏病心肌中增殖细胞核抗原和 |
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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
Study of the relationship between expression of PCNA, α-SMA and left ventricle cardiac function in myocardium of the patients with rheumatic heart disease Zhang Jinbao, Liu Weiyong, Yan Peisong, et al. Xijing Hospital Fourth Military Medical University, PLA, Xi an, 710032
【Abstract】 Objective To reveal the significance of positive expression of PCNA, α-SMA and the relationship between that and left ventricular cardiac function in myocardium of the patients with rheumatic heart disease. Methods The papillary muscle samples obtained from the patients with rheumatic heart disease were immunohistochemically stained with monoclonal antibody of PCNA, α-SMA and observed by immunoelectron microscopy. Ima-ging analysis was employed to measure the degree of immunohistochemical staining, the areas of myocardium fibrosis and the ratios between arteriolar inner and outer diameter. The data were compared with cardiac function.Results Interstitial fibrosis in rheumatic myocardium was significant. The wall of small arteries appeared thick and tune appeared narrow. Immunohistochemical PCNA positive expression was exhibited in hypertrophic cardiomyocytes and interstitial cell nuclei. α-SMA positive expression was in interstitial cells of rheumatic myocardium, and most of these cells appeared around the artery.Conclusion (1)The phenotype of myocardial cell had altered, the rate of PCNA positive expression was directly proportional to the areas of myocardium fibro[1] [2] [3] 下一页
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