风湿性心脏病心房肌缝隙连接重构与心房颤动关系研究

Relation between gap junction remodeling and atrial fibrillation in atrial myocardium of rheumatic heart disease

目的 :探讨心房肌缝隙连接之连接蛋白 (Cx)含量和分布改变与心房颤动 (AF)之间的关系。方法 :收集 6 2例患者右心耳心肌标本。 4 0例分无房颤 (NAF)、阵发性房颤 (PAF)和持续房颤 (SAF)、对照组。以Western印迹分析Cx4 3和Cx4 0含量。另 2 2例分NAF和SAF两组进行免疫组化分析 ,在激光共聚焦扫描显微镜下获取Cx4 0和Cx4 3荧光图像 ,对Cx斑数 ,Cx斑面积 ,Cx斑强度 ,及Cx斑数纵切面与横切面之比 (L/TCells)和斑面积比 (L/TArea)进行比较。结果 :Cx4 3在NAF组和SAF组间无差异。Cx4 0在NAF组和SAF组间有明显的差异 (P <0 .0 1) ,在PAF组有升高趋势。免疫组化显示GJ中Cx4 0斑较Cx4 3细小 ,荧光强度弱 (P <0 .0 5 )。Cx4 3斑数目、面积及荧光强度在NAF和SAF组间无差异。Cx4 0斑荧光强度有显著差别 (P <0 .0 5 )。Cx4 0斑L/TCells ,L/TArea在NAF和SAF组间有明显差异 (分别为P <0 .0 5和P <0 .0 1)。结论 :Cx4 3不参与AF重构 ,Cx4 0含量在房颤患者心肌中减低 ,房颤时Cx4 0斑向细胞连接的侧边分布增加。

Objective:To evaluate the relationsh ip between human atrial fibrillat ion (AF) and gap junction (GJ) remodeling in changes of connexins and intracellu lar GJ distribution pattern in rheumatic heart disease. M ethods: 62 pat ients were enrolled and tissue samples of right atrial appendage were removed in the surgery. 40 patients were divided into non-atrial fibrillation(NAF), paroxy smal atrial fibrillation(PAF),sustained atrial fibrillation(SAF) and contro l groups. Western blot analysis were carried out to detect the specific Cx43 and Cx40 protein. The other 22 patients were divided into NAF and SAF group s and all samples were carried out the immunohistochemistry and images were ob tained under the laser scanning confocal microscopy. Results: Western blot analysis showed no significant difference of Cx43 but a significant difference of Cx40 existed between NAF and SAF groups (P<0.01), and Cx 40 had a slight increase trend in PAF group. Immunohistochemical a nalysis showed that Cx40 spots were smaller and the intensity was weaker than t hose of Cx43 (P<0.05). No significant difference of cells,area and inten sity of Cx 43 spots existed between NAF and AF groups while Cx40 spot intensity was signifi cant (P<0.05). Both ratio of L/T Cells and L/T Area of Cx40 had significant differenc e between NAF and SAF group (P<0.05 and P<0.01, respectively). Conclusion: Cx43 do not participate remodeling in AF. The total amount of Cx40 was declined and the side-to-side distribution pattern was increased in AF.