风湿性心脏病心肌间质血管改建及相关细胞因子的调节

Interstitium revascularization and related cytokine regulation in myocardium of rheumatic heart disease

目的 探讨风湿性心脏病心肌组织中心肌间质血管改建及相关细胞因子的调节作用。方法 用HE染色检测心肌内小动脉内外径比值 ,用免疫组织化学及原位杂交法检测心肌中bF GF、血管内皮生长因子 (VEGF)及α 平滑肌肌动蛋白 (α SMA)的表达量 ,并将其与心肌内小动脉内外径比值对比分析。结果 风湿性心脏病心肌组织中间质纤维明显增生 ,小动脉管壁明显增厚 (内小动脉内外径比值正常组为 0 6 8± 0 15 ,病变组为 0 4 0± 0 0 4 )。bFGF、VEGF等细胞生长因子及α SMA的表达均较正常对照明显升高 ,且与心肌内小动脉内外径比值呈正相关 (bFGFr =0 719,P <0 0 1,VEGFr =0 5 38,P <0 0 5 ;α SMAr=0 82 6 ,P <0 0 1)。结论 风湿性心脏病心肌组织中间质纤维明显增生 ,小动脉管壁明显增厚 ,bFGF、VEGF等细胞生长因子及血管内皮细胞。

Objective To investigate the interstitial revascularization and related cytokine regulation in myocardium of rheumatic heart disease.Methods The specimens were stained by HE to examine the ratios between arteriolar inner and outer diameters and by immunohistochemical staining and in situ hybridization to measure the expression of bFGF,vascular endothelial growth factor (VEGF),α SMA and mRNA of bFGF.Then the relationship between ratios of arteriolar inner and outer diameters and expression of bFGF,VEGF and α SMA.Results The imaging analysis indicated that there was significant myocardium fibrosis,and the arteriolar wall became thick (0 68±0 15 vs 0 40±0 04).The expression of bFGF,VEGF and α SMA in the myocardium of rheumatic heart disease was significantly higher than that of healthy adult control group.There was a positive relationship between ratios of arteriolar inner and outer diameters and expression of bFGF,VEGF and α SMA (bFGF r =0 719, P <0 01;VEGF r =0 538, P <0 05,α SMA r =0 826, P <0 01).Conclusion There is significant myocardium fibrosis and the arteriolar wall becomes thick in the myocardium of rheumatic heart disease,and cytokines (bFGF,VEGF),endothelial cells and cells around blood vessels also take part in the revascularization.