结缔组织生长因子在风湿性心脏病患者二尖瓣乳头肌中的表达

Preliminary study of the expression of connective tissue growth factor in papillary muscles of the patients with rheumatic heart disease

目的 探讨风湿性心脏病心肌中结缔组织生长因子（CTGF）的表达与风心病心肌纤维化之间的关系.方法 应用过氧化酶标记的链霉卵白素（SP）免疫组化技术和RT-PCR技术,检测41例来自广东省心血管病研究所、中山大学第一附属医院心外科及中山大学附属第三医院心外科2004至2005年期间,行瓣膜置换术的风湿性心脏病患者和20例来自意外死亡成年健康人（对照组）的二尖瓣乳头肌中CTGF的表达.用SPSS软件分析CTGF蛋白表达量与心肌纤维化面积之间的关系.结果 风湿性心脏病患者二尖瓣乳头肌中CTGF蛋白表达量（PU值44.7±6.0）明显高于正常组（PU值2.4±0.9）,差异有统计学意义（P＜0.01）.风心病患者二尖瓣乳头肌中CTGF蛋白与CTGFmRNA表达量呈正相关（r=0.862,P＜0.01）,与心肌纤维化面积呈正相关（r=0.856,P＜0.01）.结论 CTGF在风心病二尖瓣乳头肌较成人正常二尖瓣乳头肌的表达有明显增高,提示CTGF在风湿性心脏病心肌纤维化中可能起重要作用.

Objective To investigate the expression and the effect of connective tissue growth factor （CTGF） on rheumatic myocardial fibrosis of rheumatic heart disease （RHD）.Methods The papillary muscles samples were obtained from patients with RHD during mitral valve replacement.The expression of TGF-β1,CTGF mRNA and CTGF protein were detected with semiquantitative RT-PCR technique and immunohistochemistry technologyin the papillary muscles cell from 41RHD patients and 20 normal papillary muscles samples.The area of myocardial fibrosis was measured by imaging analysis system.SPSS package was used to analyze the relationship between the expression of CTGF and the area of myocardial fibrosis.Results Compared with normal controls （PU 2.4 ± 0.9）,the mean level of CTGF protein expression in the papillary muscles samples of the RHD patients （PU 44.7 ± 6.0） was significantly increased （P ＜ 0.01）.The expression of CTGF protein in papillary muscles of RHD was positivelycorrelated with the expression of CTGFmRNA （r =0.862,P ＜ 0.01） and the area of myocardial fibrosis （r =0.856,P ＜ 0.01）.Conclusions Compared with normal controls,CTGF expression in the papillary muscles of the RHD patients is significantly increased,which suggests CTGF may play animportant role in myocardial fibrosis of RHD.