风湿性心脏病慢性心房颤动患者心房肌细胞核因子-κB、细胞间黏附分子-1及血管间黏附分子-1表达水平的研究

Study on the expression levels of nuclear factor kappa B, ICAM-1 and VCAM-1 in patients with rheumatic heart disease and chronic atrial fibrillation

目的 研究风湿性心脏病伴或不伴慢性心房颤动（简称房颤）患者右心房心肌细胞核因子-κB（NF-κB）、细胞间黏附分子-1（ICAM-1）及血管间黏附分子-1（VCAM-1）的表达,探讨房颤与NF-κB、ICAM-1及VCAM-1表达之间的关系.方法 将26例风湿性心瓣膜病患者分为两组,其中窦性心律（简称窦律）组10例、慢性房颤组16例,术中获取右心耳组织,分别进行苏木素-伊红（HE）和Masson染色,观察炎性细胞浸润和心肌纤维化程度.采用免疫组织化学染色法测定心肌细胞NF-κB、ICAM-1及VCAM-1表达水平.结果 慢性房颤组患者炎性细胞浸润和心肌纤维化程度较窦律组明显加重,NF-κB和ICAM-1的表达程度显著增加（P＜0.01）,VCAM-1的表达水平高于窦律组,差异有统计学意义（P＜0.05）.结论 风湿性心脏病患者慢性房颤的发生可能与NF-κB、ICAM-1及VCAM-1的表达增高有关.

Objective To investigate the influence of atrial fibrillation （AF） on nuclear factorkappa B （NF-tB）,intercellar adhesion molecule-1 （ICAM-1） and vascular cell adhesion molecule-1 （VCAM-1） in the right atrial myocytes when the patients with rheumatic heart disease suffered from AF or not.Methods Twenty-six patients with rheumatic heart disease （RHD） were enrolled.Ten patients had no history of atrial fibrillation and sixteen had atrial fibrillation.Atrial tissue was obtained from the right atrial appendage during heart surgery.The inflammatory cell infiltration and the degree of myocardial fibrosis were observed with HE and Masson staining.The expression levels of NF-κB,ICAM-1 and VCAM-1 was examined with immunocytochemical staining.Results The inflammatory cell infiltration and the degree of myocardial fibrosis were elevated in patients with AF.The level of NF-κB,ICAM-1 and VCAM-1 were significantly elevated in patients with atrial fibrillation compared with control group（P ＜ 0.01）.Conclusion The excessive expression of NF-κB,ICAM-1 and VCAM-1 may be involved in AF in patients with rhematic heart disease.