扩张型心肌病患者左心室心肌组织中转化生长因子β、结缔组织生长因子和胶原蛋白的表达水平及临床意义

Expressions and clinical significance of transforming growth factor-β,connective tissues growth factor and collagen in left ventricular myocardium tissue of patients with dilated cardiomyopathy

目的分析扩张型心肌病(DCM)患者左心室心肌组织转化生长因子(TGF)-β1、TGF-β2、结缔组织生长因子(CTGF)、Ⅰ型胶原蛋白(ColⅠ)和Ⅲ型胶原蛋白(ColⅢ)mRNA的表达水平,并探讨其临床意义。方法收集9例DCM患者受体心脏(DCM组)及7例移植失败供体心脏(对照组)的左心室心肌组织。病理切片染色观察心肌纤维化程度等,计算胶原容积百分比(CVF)。实时荧光定量PCR检测心肌组织TGF-β1、TGF-β2、CTGF和胶原蛋白的mRNA表达水平。结果 DCM组左心室心肌组织病理切片苏木精-伊红染色可见心肌结构排列紊乱、心肌细胞体积增大,苦味酸-天狼星红染色可见DCM组大量红色胶原纤维沉积,且CVF增加(均P<0.05)。DCM患者左心室心肌组织中TGF-β1、TGF-β2、CTGF、ColⅠ和ColⅢ的mRNA表达水平高于对照组,且均与CVF呈正相关(均P<0.05)。结论 TGF-β1、TGF-β2、CTGF和胶原蛋白在DCM患者心室肌组织中表达上调,其或可用于评价DCM患者心肌纤维化程度。

Objective To analyze the expression levels of transforming growth factor(TGF)-β1,TGF-β2,connective tissue growth factor(CTGF),collagen Ⅰ(Col Ⅰ) and collagen Ⅲ(Col Ⅲ) mRNAs in left ventricular myocardium tissues of the patients with dilated cardiomyopathy(DCM),and to investigate their clinical significance.Methods The left ventricular myocardium tissues from receptor hearts of 9 patients with DCM(DCM group) and 7 donor hearts failed in transplantation(control group) were collected.Pathological section staining was performed to observe the degree of myocardial fibrosis,etc.,and collagen volume fraction(CVF) was calculated.The expressions of TGF-β1,TGF-β2,CTGF,and collagen mRNAs in the myocardium tissues were detected by quantitative real-time fluorescent PCR.Results In the DCM group,the myocardial structure disorder and cardiomyocyte volume enlargement by hematoxylin-eosin staining,a great quantity of red collagen fiber deposition by picric-sirius red staining,as well as increased CVF,were found(all P<0.05).The expression levels of TGF-β1,TGF-β2,CTGF,Col Ⅰand Col Ⅲ mRNAs in the left ventricular myocardium tissues of the DCM group were higher than those of the control group, and were all positively correlated with CVF(all P<0.05).Conclusion The TGF-β1,TGF-β2,CTGF,and collagen expressions were up-regulated in myocardium tissues of patients with DCM,and may be applied to evaluating the degree of myocardial fibrosis in DCM patients.