摘要
目的 :探讨 p5 3和 Bcl 2蛋白在急性心肌梗死 (AMI)猝死者心肌细胞凋亡中的作用。方法 :用凋亡原位末端标记检测 (TU NEL)法检测 2 0例 AMI猝死者和 10例心脏正常车祸死亡者心肌细胞凋亡 ,用免疫组化法检测 p5 3和 Bcl 2蛋白在心肌细胞中表达水平 ,并探讨其相互关系。结果 :AMI猝死者梗死区心肌细胞凋亡数为 (5 5 7.95± 144 .10 )个 / 10 0 0个 ,明显高于正常对照组 (34.30± 2 0 .6 8)个 / 10 0 0个 (P<0 .0 5 ) ;猝死者梗死区心肌细胞中 p5 3蛋白表达阳性细胞数为 (4 41.6 5± 131.6 8)个 / 10 0 0个 ,明显高于正常对照组 (2 0 .2 0±2 6 .2 7)个 / 10 0 0个 (P<0 .0 5 ) ,且与梗死区心肌细胞凋亡数成明显的正相关性 (r=0 .6 5 5 3,P<0 .0 0 2 ) ;Bcl 2蛋白表达阳性细胞数为 (36 .2 5± 43.17)个 / 10 0 0个 ,明显低于正常对照组 (10 0 .10± 71.34)个 / 10 0 0个 (P<0 .0 5 ) ,且与梗死区心肌细胞凋亡数成明显负相关性 (r=- 0 .810 3,P<0 .0 0 1) ;梗死区心肌细胞内 p5 3与Bcl 2蛋白表达数之间呈明显的负相关性 (r=- 0 .80 78,P<0 .0 0 1)。不同支数冠状动脉病变猝死者梗死区心肌细胞的凋亡数 1支者 (5 0 6 .38± 175 .88)个 / 10 0 0个 ,2支者 (5 5 4.38± 92 .15 )个 / 10 0 0个 ,3支者 (6 6 8.
Objective:To investigate the expression and significance of p53 and Bcl2 protein in myocyte apoptosis in infarct area in patients with sudden death caused by acute myocardial infarction(AMI).Methods:TdTmediated dUTP nick end labeling(TUNEL) was applied to monitor the myocyte apoptosis.Bcl2 and p53 protein expressions were assessed by immunohistochemistry,and correlation analysis was performed. Results :The amount of apoptosis myocytes in infarct area in patients with sudden death caused by AMI was significantly higher than that in control group 〔(557 95±144 10)cells/1 000 cells vs.(34 30± 20 68)cells/1 000 cells, P <0 05〕 The expression of p53 protein of myocytes in the infarct area in the group studied was also significantly higher than that in the control group 〔(441 65±131 68)cells/1 000 cells vs.(20 20±26 27)cells/1 000 cells, P <0 05〕.The amount of apoptotic myocytes in the infarct area was positively correlated to p53 protein expression ( r =0 655 3, P <0 002).The expression of Bcl2 positive protein in myocytes of the infarct area in the group studied was significantly lower compared with the control group 〔(36 25±43 17)cells/1 000 cells vs.(100 10±71 34)cells/1 000 cells, P <0 05〕.The amount of apoptotic myocytes in the infarct area was negatively correlated to Bcl2 protein expression( r =-0 810 3, P <0 001).In addition,significantly negative correlation was found between expression of p53 and Bcl2 protein in myocytes of the infarct area ( r =-0 807 8, P <0 001).However,the amount of apoptotic myocytes in 1vessel,2vessel and 3vessel disease were (506 38±175 88)cells/1 000 cells,(554 38±92 15)cells/1 000 cells and (668 25±127 19)cells/1 000 cells,respectively,significantly higher than those in control group (all P <0 05).The amount of p53 protein expression of myocytes in 1vessel,2vessel and 3vessel disease were (389 00±150 45)cells/1 000 cells,(455 88±105 20)cells/1 000 cells,(518 50±123 95)cells/1 000 cells,respectively,significantly higher compared with the control group (all P <0 05).The amount of Bcl2 protein expression of myocytes in the 2vessel disease group 〔(25 25±14 10)cells/1 000 cells〕 was significantly lower than that in the control group( P <0 05).No significant differences were found between the 1vessel group and the 3vessel disease group with the control group 〔(58 13±62 38)cells/1 000 cells,(14 50± 5 32)cells/1 000 cells vs.(100 10±71 34)cells/1 000 cells,both P >0 05〕.The results showed that the more vessels involved,the more increased expression of p53 protein,and the more decreased expression of Bcl2 protein.No differences were found among the groups in respect to the amount of apoptosis myocytes,the expression of p53 and Bcl2 protein in 1vessel,2vessel,and 3vessel disease.This might be due to limited number of cases.Conclusions:Remarkable appearance of apoptosis in myocytes of infarct area induced by AMI was found.It is correlated with p53 protein upregulation and Bcl2 protein downregulation.
出处
《中国危重病急救医学》
CAS
CSCD
2000年第11期645-649,共5页
Chinese Critical Care Medicine
基金
卫生部科研基金资助项目!(No.1996 1116 )
关键词
细胞凋亡
P53蛋白
心肌梗死
急性
猝死
myocyte apoptosis
p53 protein
Bcl-2 protein
acute myocardial infarction
