风湿性心脏病合并慢性心房纤颤患者心房Ⅰ、Ⅲ型胶原蛋白的表达

Expression of type Ⅰ and Ⅲ collagen protein in patients with atrial fibrillation complicated with rheumatic heart disease

目的:探讨风湿性心脏病合并慢性心房纤颤患者心房胶原的组织学分布和Ⅰ、Ⅲ型胶原蛋白表达的变化。方法:应用Masson和SP免疫组化染色方法,结合数字图像分析方法,观测4例正常人和6例风湿性心脏病合并慢性心房纤颤患者心房胶原的组织学分布和Ⅰ、Ⅲ型胶原蛋白的表达。结果:Masson染色显示,风湿性心脏病合并慢性心房纤颤患者心房的部分区域心肌细胞间隙增大,胶原松散、断裂或大量聚集。正常心房Ⅰ、Ⅲ型胶原广泛分布,均可分为粗、细不等的条状纤维。风湿性心脏病合并慢性心房纤颤患者心房Ⅰ、Ⅲ型胶原表达大多区域正常,部分区域发生极度重排。数字图像分析显示:正常心房Ⅰ型胶原含量较Ⅲ型胶原多,风湿性心脏病合并慢性心房纤颤组Ⅰ型和Ⅲ型胶原含量明显增多。结论:风湿性心脏病合并慢性心房纤颤患者心肌的间质松散,胶原增多。Ⅰ和Ⅲ型胶原纤维形态上出现重构,含量增加。这可能是风湿性心脏病合并慢性心房纤颤时心功能异常的形态学改变之一。

Aim ： To investigate the changes of histological distribution of collagen and type Ⅰand Ⅲcollagen expression in atrium myocytes of patients with atrial fibrillation complicated with rheumatic heart disease. Methods：The histological distribution of collagen and expression of type Ⅰand Ⅲ collagen in human atrium of normal and patients was determined by Masson staining,immunohistochemistry and digital-image analysis technology. Results：The result by Masson staining was the scattering collagen of inter-space split or assemble abnormally in hypertrophy tissue of atrial fibrillation. And the gap of atrial myocytes broadened. The type Ⅰand Ⅲ collagen fibers in normal atrium distributed widely and were connected into nets. The expressions of type Ⅰ and Ⅲ collagen were mostly normal in atrium of patients, but a few were redis- tributed severely in some areas. The results of digital image analysis showed that type I collagen content was much more than that of type Ⅲ in normal atrium while type Ⅰand type Ⅲ collagen increased remarkably in atrium of patients. Conclusion ： The expressions of collagen are redistributed and increased greatly in atrium of patients, which may be one of the morphological changes that cause abnormal heart function in patients with atrial fibrillation complicated with rheumatic heart disease.