MicroRNA在心房颤动的心房重构过程中的应用研究

Application research of microRNA on atrial structural remodeling in patients with atrial fibrillation

目的研究和分析microRNA(miRNA)在心房颤动的心房重构过程中的作用。方法选取于2012年9月至2013年11月在该院接受治疗的心房颤动患者198例作为研究对象,依据患者实际病况分成心房颤动组(104例)和窦性心律(窦律)组(94例),均行外科开胸术治疗,术中取样两组患者右心耳组织进行检测和分析,记录两组患者心房组织中miRNA的表达量和Cx43mRNA表达量,并采取苏木精-伊红染色观察患者心房组织形态的变化情况。结果心房颤动患者心房组织形态学发生明显变化,主要表现为心房细胞异常增大,肌纤维异常增粗且断裂,同时表现出大小不均、排列紊乱、细胞核增大、间质纤维化明显等特点。心房颤动组miRNA在心房组织中的表达量[(0.614 9±0.175 7)×103]明显低于窦律组[(2.298 6±0.390 6)×103],差异有统计学意义(t=39.743,P<0.01);但两组Cx43mRNA表达量比较,差异无统计学意义(t=1.224,P>0.05);心房颤动组Cx43蛋白表达量[(0.576 2±0.201 0)×103]显著低于窦律组[(1.145 0±0.373 9)×103],差异有统计学意义(t=13.507,P<0.01)。结论心房颤动患者心房重构明显;同时该类患者心房组织中miRNA的表达量明显下降,致使其相关的靶基因Cx43蛋白的表达量也随之下调,二者呈非负相关,说明miRNA并不能直接通过对Cx43的表达调控而参与到心房重构中。

Objective To study and analyze the effect of microRNA on atrial structural remodeling in patients with atrial fibrillation（AF）. Methods Totally 198 patients with AF,who received treatment from September 2012 to November 2013,were selected and divided into AF group（n=104） and sinus rhythm（SR） group（n=94） according to patients′ actual condition. All the patients were with thoracotomy. The right auricle of the heart tissue in the two groups was sampled during the surgery for detection and analysis to record the expression quantity of microRNA and Cx43mRNA. Hematoxylin-eosin（HE） staining was adopted to observe changes of atrial tissue morphology. Results Atrial tissue histomorphology of the patients with AF changed obviously, mainly on abnormal increase of atrial cell,abnormal enlargement and rupture of muscle fiber,uneven size,disordered arrangement,increase of neucleus,interstitial fibrosis and so on. The expression quantity of microRNA atrial tissue in AF group[（0.614 9±0.175 7）×10^3] was obviously lower than that in SR group[（2.298 6±0.390 6）×10^3] with statistically significant difference（t= 39.743,P〈0.01）. The expression quantity of Cx43mRNA had no statistically significant difference between the two groups（t=1.224, P〈0.05）. The expression quantity of Cx43 protein in AF group[（0.576 2±0.201 0）×10^3] was remarkable lower than that in SR group [（1.145 0±0.373 9）×10^3],and the difference was statistically significant（t=13.507,P〈0.01）. Conclusion Atrial remodeling of the patients with AF is significant,at the same time,the expression quantity of microRNA in atrial tissue decreases dramatically, which resulting in the down-regulation of expression quantity of Cx43 protein related to target gene,and the microRNA and Cx43 reflect the negative relationship,which shows that microRNA cannot participate in the atrial structural remodeling through regulating the expression of Cx43 directly.