摘要
目的:观察内质网应激(ERS)相关因子Caspase-12和GRP78在心脏停跳与不停跳二尖瓣置换术(MVR)的表达。方法 :30例择期行MVR的风湿性心脏病(RHD)二尖瓣狭窄(MS)患者随机分为心脏不停跳组(BH组,n=15)与心脏停跳组(CA组,n=15),分别于体外循环(CPB)转流开始前(T0)、主动脉阻断30min后(BH组为CPB开始后30 min,T_1)及缝合右心房前(T_2)收集右心房心肌组织,通过RT-PCR法检测两组心肌Caspase-12和GRP78的表达,同时采用免疫组织化学法检测两组心肌Caspase-12和GRP78阳性着色情况。结果:CA组Caspase-12 m RNA的表达量在T_1时段增高,在T_2时段显著增高(P<0.05);BH组仅在T_2时段表达增高(P<0.05);CA组在T_1、T_2时间段Caspase-12 m RNA表达量均高于BH组(P<0.05)。两组GRP78 m RNA的表达量在T_1时段均增高,在T_2时段CA组表达量高于BH组(P<0.05)。CA组T_2时间段Caspase-12与GRP78免疫组化染色阳性细胞数均高于BH组(P<0.05)。结论 :心脏不停跳MVR能够通过减轻ERS反应来加强CPB过程中心肌保护。
Objective To observe the expression of Caspase-12 and GRP78 of endoplasmic reticulum stress （ERS） in cardiac arrest and beating heart mitral valve replacement Methods Thirty patients with rheumatic heart disease mitral stenosis were randomly divided into beating heart group （BH, n=15 ） and cardiac arrest group（CA, n = 15）. Both groups accepted MVR by beating heart surgery and cardiac arrest surgery under cardiopulmonary bypass （CPB） respectively. Right atrial myocardial tissues were collected at prior the start of CPB （T0）, after aortic cross-clamping 30 minutes （BH group 30 minutes after CPB, T1） and stitched right atrium （T2） respectively. The method of reverse transcriptase polymerase chain reaction （RT-PCR） was applied to detect the expression level of Caspase-12 and GRP78 in two groups and positive staining of Caspase-12 and GRP78 of myocardial tissue slices in both groups was observed by immunohistochemical method. Results The expression of Caspase-12 in CA group heightened at Tland significantly increased at T2 （P 〈 0.05） but the expression of Caspase-12 in BH group had increased in T2 only （P 〈 0.05）. Caspase-12 in CA group expressed higher than that in BH group at T1 and T2. The expression of GRP78 had increased at T1 in two groups but it in CA group expressed higher than that inBH group at T2. The number of positive staining of Caspase-12 and GRP78 in CA group was higher than that in BH group at T2. Conclusion MVR of beating heart can reduce the reaction of ERS to enhance the myocardial protection under CPB.
作者
马宪鲁
张申
陈德海
郑宝石
谢晓勇
周华富
MA Xia-lu ZHANG Shen CHEN De-hal ZHENG Bao-shi XIE Xiao-yong ZHOU Hua-fu(Dept of Cardiac Surgery,Jining NO.1 People＇s Hospital Jining 272000 China)
出处
《实用医学杂志》
CAS
北大核心
2016年第18期3030-3033,共4页
The Journal of Practical Medicine
基金
广西科学研究与技术开发计划项目(编号:桂科攻1355005-2-3)
广西自然科学基金项目(编号:2013GXNSFAA192052)
