心房颤动患者右心房肌闰盘重构的研究

Study of Intercalated Discs Remodeling in Right Atrium during Atrial Fibrillation in Human

目的:探讨心房颤动(房颤)患者右心房肌细胞间闰盘相关蛋白表达变化与房颤发生并维持的意义。方法:心外科患者53例,其中房颤患者27例(房颤组),窦性心律患者26例(窦律组),在建立体外循环前取右心房组织。分别将心房组织提取mRNA和制作病理组织切片,部分组织送电镜检查。用RT-PCR方法检查Cx40、Cx43mRNA表达变化,用免疫组化方法检测Cx43、N-钙黏素的分布变化。结果:两组患者Cx40、Cx43mRNA表达无变化,免疫组化结果显示房颤组缝隙连接、N-钙黏素分布发生不均一,光镜、电镜证实房颤组缝隙连接发生侧边化分布明显。结论:闰盘相关蛋白表达改变在房颤的维持中发挥重要作用。

Objective： To investigate the significance between changes of the associated protein of intercalated discs in right atria and genesis and maintenance of atrial fibrillation （AF）. Methods： Hight atrial tissue samples; of fifty-three patients undergoing cardiac surgery were examined. The patients were divided into two groups：twenty-seven with AF and twenty-six without AF and right atrium tissues were selected before extracorporeal circulation mRNA and pathological slice of atrium were made respectively and partial tissues were tested by electronic microscope.mRNA of connexin40 （Cx40） and connexin 43 （Cx43） were semi-quantified by reverse transcription-polymerase chain reaction （RT-PCR） and the distribution change of Ncadherin and Cx43 was analyzed by immunohistochemistry. Results： mRNA of Cx 40 and Cx43 in two groups was not significantly alterd. Immunohistochemistry revealed that Cx43 and N-cadherin redistributed heterogenously and electronic microscopy revealed that side to side of gap junctions was obviously in the AF group. Conclusion： The change of associated protein of intercalated discs is strongly related with AF self-persistence.