摘要
目的阐明慢性风湿性心脏病（简称风心病）心肌细胞表型变化及其与心肌纤维化的关系。方法取风心病二尖瓣乳头肌，以成人及胎儿正常乳头肌为对照，用增殖细胞核抗原（ＰＣＮＡ）和α平滑肌肌动蛋白（αＳＭＡ）单抗行免疫组化、免疫电镜观察，用图像分析仪定量分析。结果风心病心肌间质纤维化（２４４７％±３０５％）和小动脉内外径比值（０４０５±００３６），与正常心肌比较差异有显著意义。风心病组ＰＣＮＡ阳性表达不仅存在于间质细胞，且多见于心肌细胞中；αＳＭＡ在风心病组中阳性表达细胞增多。阳性细胞胞浆中粗面内质网明显增多，有大量核糖体和发达高尔基体。ＰＣＮＡ和αＳＭＡ阳性表达程度随心肌纤维化加重而增强（Ｐ＜００１）。结论ＰＣＮＡ和αＳＭＡ在慢性风心病乳头肌中呈阳性表达，亦见于胎儿心肌中。病变心肌细胞不仅有收缩表型，也有合成表型。阳性表达细胞进入增殖状态。
Objectives:To reveal the change of chronic rheumatic cardiomyocyt phenotype and its relationship with myocardium fibrosis. Methods The papillary muscles samples were obtained from patients with rheumatic heart disease during mitral valve replacement. Normal papillary muscles samples obtained from adult and fetal heart during autopsy in control group. The specimens were examined using immunohistochemistry and immunoelectron microscopy observation with monoclonal antibody of antiproliferating cell nuclear antigen (PCNA) and anti α smooth muscles actin (α SMA), and imaging analysis was performed. Results The interstitial fibrosis (24 7%±3.05%) and the ratio between inner and outer diamater of arteriolas (0.405±0.035) in rheumatic myocardium were higher significantly than those in normal myocardium. Immunohistochemical PCNA expression was not only in interstitial but also in hypertrophic cardiomyocytes of rheumatic heart disease. The positive expression in rheumatic myocardium increased. There were a lot of rough endoplasmic reticula, ribosomes and Golgi bodies in cytoplasm of PCNA and α SMA positive cells. The degree of PCNA and α SMA positive expression was increased with enlargement of fibrosis areas. Conclusions There is not only a high expression of PCNA and α SMA in the myocardium of patients with rheumatic heart disease but also in fetal myocardium. We suggested that pathological myocardial cells are constructive phenotype and synthetive phenotype. PCNA and α SMA positive expression cells are in the proliferating stage, they take part in fibrotic progress and vascular reconstruction in the myocardium.
出处
《中华医学杂志》
CAS
CSCD
北大核心
1998年第5期337-339,共3页
National Medical Journal of China
关键词
风湿性心脏病
乳头肌
增殖细胞核抗原
肌动蛋白
Rheumatic heart disease
Myocardium
Endomyocardial fibrosis
Proliferating cell nuclear antigen
Actins
