心脏瓣膜病患者心肌组织脂联素抵抗及其相关机制探讨

Influence of adiponectin resistance on heart valve disease and it's molecular mechanism

目的探讨心脏瓣膜病患者心肌组织脂联素抵抗及其相关机制。方法选择行体外循环下瓣膜置换手术的心脏瓣膜病患者36例为观察组,心脏移植捐献者及心脏外伤需手术患者22例为对照组。两组均手术中体外循环建立时剪除心肌组织,用RT-PCR法检测脂联素表达,Western Blot法检测脂联素下游通路重要分子腺苷酸活化蛋白激酶(AMPK)活性,HE染色观察心肌组织病理情况。结果与对照组相比,观察组心肌组织脂联素mRNA表达显著升高,AMPK活性显著降低,P均<0.05。心肌组织病理改变与相应心功能特点相符。结论心脏瓣膜病患者心肌组织脂联素水平显著升高,脂联素受体后AMPK磷酸化水平降低导致脂联素无法发挥正常的心肌保护效应,心脏瓣膜病患者的心肌组织出现脂联素抵抗。

Objective To investigate the effect of adiponectin resistance on heart valve disease and the related resist -ance mechanism .Methods Thirty-six patients undergoing cardiopulmonary bypass （ CPB） heart valve replacement surger-y （ the treatment group ） and 22 cases of heart transplant donors who needed heart surgery （ the control group ） were select-ed.The myocardial tissues which were cut off in the cardiac operation under CPB were collected .The adiponectin expres-sion in the myocardial tissue samples was detected by RT-PCR.The adiponectin important molecular pathways downstream AMP-activated protein kinase （ AMPK） activity was detected by Western blotting .The cardiac pathology was detected by HE staining method.Results Compared with the control group , adiponectin mRNA was significantly higher , and the level of downstream pathways AMPK phosphorylation was significantly lower in the treatment group （all P〈0.01）.Histopathol-ogy results complied with the appropriate cardiac function of myocardial performance .Conclusion The adiponectin levels in the tissues of patients with heart valve disease are significantly increased , but adiponectin receptor AMP-activated protein kinase （ AMPK） phosphorylation levels are decreased , thus adiponectin can not play the protective effect , and myocardial tissues of patients show adiponectin resistance .