瓣膜性心脏病合并慢性心力衰竭患者右心房肌整合素连接激酶基因mRNA表达水平的变化及临床意义

The expression level and significance of integrin-linked kinase m RNA in right auricular appendage myocardium in patients with valvular heart disease and chronic heart failure

目的观察慢性心力衰竭患者右心房肌整合素连接激酶(integrin-linked kinase,ILK)基因m RNA表达水平变化,探讨其与慢性心力衰竭的相关性及可能的临床意义。方法选取2015年1月至2015年12月于本院住院手术的慢性心力衰竭患者13例为研究对象,取其术中常规切除的右心耳心房肌标本纳入心力衰竭组;收集同期健康成人捐献的移植后剩余的右心耳心肌组织标本6例纳入对照组。所有患者术前均接受常规心脏彩超进行心功能指标检查。提取心房肌组织总RNA,以甘油醛-3-磷酸脱氢酶(GAPDH)基因为内参,采用实时荧光定量聚合酶链反应(PCR)相对定量检测正常人和心力衰竭患者ILK基因m RNA表达水平。采用2-ΔΔCt法计算ILK表达的相对定量结果。结果目的基因ILK和内参基因GAPDH的熔解曲线呈单峰,扩增产物特异性良好;慢性心力衰竭患者左室射血分数[(34.96±4.29)%︰(58.03±3.15)%]与ILK基因m RNA表达水平[(1.81±0.09)︰(4.72±0.24)]较正常人均显著降低(P<0.01)。结论与正常人相比,慢性心力衰竭患者心房肌ILK基因表达明显下调,ILK基因表达水平的改变可能参与了心力衰竭发生的分子机制。

Objective To observe the expression levels of integrin-linked kinase（ILK） m RNA in patients of chronic heart failure（CHF）, and to evaluate the relationship between the changes of ILK gene m RNA expression level, as well as its clinical significance. Method From January 2015 to December 2015, a total of 13 hospitalized surgical patients with CHF participated in this study. 13 cases of right atrial appendages samples of these patients were obtained during cardiac surgeries（CHF group）; 6 cases of right atrial appendages donated by normal adults were set as control group. Echocardiography was performed to determine left ventricular ejection fraction（LVEF） in all patients before operation. Extracted total m RNA of obtained atrial tissue; m RNA content of ILK was measured by relatively SYBR Green Dye real-time quantitative polymerase chain reaction（PCR） with housekeeping GAPDH gene as the internal control. Analyzed the relative quantification of ILK expression by 2-ΔΔCt method. Result The dissociation curve of ILK and GAPDH showed single peak, accounting a good specificity in PCR amplified products. The LVEF [（34.96±4.29）% ︰（58.03±3.15）%] and m RNA expression levels of ILK [（1.81±0.09） ︰（4.72±0.24）] were reduced in CHF group compared to control group（P〈0.01）. Conclusion The reduction of ILK m RNA expression is closely related with poorer cardiac function. The alterations of ILK gene expression levels may participate in molecular basis of heart failure.