摘要
目的 了解风湿性心脏病 (风心病 )心肌中生长因子表达的特点 ,探讨生长因子与风心病心肌纤维化的关系。方法 风心病病人 30例 ,其中二尖瓣狭窄 (MS)为主 16例 ,二尖瓣关闭不全 (MR)为主 14例 ,术中取左室乳头肌 ,成年及胎儿正常乳头肌各 5例为对照 ,Masson染色检测心肌胶原 ;免疫组化方法观察转化生长因子 β1(TGFβ1)、碱性成纤维细胞生长因子 (bFGF)和血管内皮生长因子 (VEGF)在心肌中的表达 ,均用图像分析仪定量分析。结果 结果TGFβ1、bFGF在风心病心肌细胞中阳性表达增强 ,表达强度与心肌纤维化面积呈正相关 (P <0 0 5 ) ;bFGF在MR组的表达 (5 2± 11)Od/ μm2 强于MS组 (39± 12 )Od/ μm2 ;VEGF和bFGF还在心肌血管内皮细胞中表达。结论 细胞生长因子TGFβ1、bFGF均在风心病心肌纤维化形成中起作用 ,bFGF可能参与了风心病心肌细胞肥大过程 ,VEGF和bFGF还可能通过刺激新生血管的生成而参与风心病心肌重构 ,因此调控此类生长因子 ,可能为逆转风心病心肌纤维化展示了新思路。
Objective To investigate the expressive feature of growth factors in myocardium of rheumatic heart disease (RHD),and the effects of growth factors on rheumatic myocardial fibrosis.Methods Of 30 RHD patients,16 were with mitral stenosis (MS) and 14 with mitral regurgitation (MR).The left papillary muscle specimens were obtained during the operation on mitral valve replacement.The control specimens were from autopsis of 5 healthy adults and 5 fetuses.The myocardium specimens were stained with Masson stain to observe the degree of collagen hyperplasia;and immunohistochemically stained to examine the expression and distribution of transforming growth factor beta-1 (TGFβ 1),basic fibroblast growth factor (bFGF),and vascular endothelial growth factor (VEGF).Imaging analysis was employed to measure the area of myocardial fibrosis and the degree of immunohistochemical staining.Results RHD myocardium showed significant collagen hyperplasia.The positive expression degree of TGFβ 1 and bFGF in rheumatic cardiomyocytes was increased and correlated positively with the area of myocardial fibrosis ( P <0 05).bFGF expression (Od/μm 2) in MR group (52±11) was stronger than that in MS group (39±12).Both VEGF and bFGF were stained also in vessel endothelial cells.Conclusion TGFβ 1 and bFGF not only take part in but also play a key role in myocardial fibrosis.bFGF may be correlated with hypertrophy progress of cardiomyocytes in RHD.VEGF and bFGF may take part in rheumatic myocardial remodeling by inducing new vessels.So regulating these growth factors may be a new method to reverse myocaardium fibrosis in RHD.
出处
《中华风湿病学杂志》
CAS
CSCD
2000年第5期274-276,共3页
Chinese Journal of Rheumatology
基金
国家自然科学基金!资助项目 (39870 790 )
关键词
风湿性心脏病
乳头肌
生长因子
表达
Rheumatic heart disease
Growth substances
Myocardium
Fibrosis
