GLUT4、TNF-α-mRNA、iNOS在冠心病患者冬眠心肌中的表达和意义

Significances and expressions of TNF-α and GLUT4 and iNOS in hibernating myocardium of patients with cardiac arterial disease

目的探讨冬眠心肌细胞内GLUT4、TNF-α-mRNA、iNOS的变化和意义。方法10例行冠脉搭桥术的冠心病患者,术前一周内用多巴酚丁胺超声负荷试验结合多普勒组织成像确定冬眠心肌及正常心肌的位置,搭桥术中根据检测结果进行取材(分别取正常心肌和冬眠心肌),并经电镜证实。Western-blot法测GLUT4、iNOS蛋白表达情况,ISH法测TNF-α-mRNA的活性,Tunel法测心肌细胞凋亡情况。结果冬眠心肌细胞内GLUT4、TNF-α-mRNA、iNOS的表达及心肌细胞凋亡数较正常细胞高;冬眠心肌TNF-α-mRNA与心肌细胞凋亡数、iNOS的蛋白表达相关(P<0.05),r分别为0.857、0.784。结论慢性缺血缺氧时,心肌细胞内GLUT4、TNF-α-mRNA、iNOS表达增加。TNF-α可介导细胞凋亡,并促进iNOS表达,GLUT4、TNF-α、iNOS是冬眠心肌形成的重要分子生物学因子。

Obiective To observe expressions and significance of glucose transport type 4（GLUT4）,tumor necrosis factor-α （TNF-α）-mRNA, inducible nitric oxide synthase （iNOS） in hibernating myecardium （HM）. Methods Ten patients with coronary artery disease scheduled for bypass surgery underwent preoperative dobutamine stress echo-cardiography and doppler tissue image to check the position of HM. The normal myocardium （NM） and the HM were obtained in operation, conformed by electron microscope, iNOS and GLUT4 were detected by Western-blot, TNF-α-mRNA were detected by ISH and cardiomyocyte apoptosis were detected by Tunel method. Results The expression of GLUT4 ,TNF-α-mRNA ,iNOS and cardiomyecyte apoptosis are significandy increased in HM compared with NM. TNF-α-mRNA and PCN（positive cardiomyocyte nuclei） of apoptosis,iNOS are positive correlation （r=0.857,0.784 P〈0.05）.Condusion It increased for expressions of TNF-α-mRNA, GLUT4 and iNOS in HM.TNF-α intervene cardiomyocyte apoptosis, and promote the expression of iNOS. GLUT4, TNF-α ,iNOS take part in the process of HM formation.