风湿性心脏病患者心肌、骨骼肌细胞m tDNA突变的相关性研究

Correlation of DNA deleted rate of the cardiac myocytes and that of the skeletal myocytes in rheumatic heart disease

目的 探讨风湿性心脏病 (风心病 )患者心肌细胞与骨骼肌细胞线粒体 DNA(mt DNA)突变的相关性。方法 随机选取 5 6例风湿性二尖瓣狭窄为主患者 (下称实验组 ,冠心病除外 ) ,另选 10例意外死亡的成人做为正常对照组。术中切取后乳头肌作为心室肌标本 ,胸大肌作为骨骼肌标本。定量每例患者心肌及骨骼肌mt DNA4 977缺失率 ,分析其相关性及与心功能的关系。结果 实验组心肌 m t DNA4 977缺失率为 1.18%～ 13.75‰ ,对照组为 0～ 0 .0 6‰ ,两者有显著性差异 (P<0 .0 1)。随着心功能恶化 ,实验组心肌 m t DNA4 977缺失率增加。按NYHA心功能分级 , 级 (B组 )、 级 (C组 )、 级 (D组 )心肌 mt DNA4 977缺失率分别为 3.79‰、6 .32‰和9.2 8‰ ,两两比较 ,P<0 .0 5。实验组心肌、骨骼肌 mt DNA4 977缺失率呈正相关 (γ=0 .75 ,P<0 .0 1)。结论 风心病患者的心肌 mt DNA4 977缺失率与其心功能损害程度密切相关 ;其骨骼肌 m t DNA4 977缺失率与心肌 mt DNA4

Objectire To explore the correlation of mtDNA 4977 deleted rate of the cardiac myocytes and that of the skeletal myocytes in rheumatic heart disease Methods 56 patients with simple mitral stenosis were randomly screened as the test group, meanwhile 10 cases of accidental dead adults were selected as the control group The posterior papillary muscles and pectoralis major were taken during the operation as the sample to investigate the changes of ventricular muscles and skeletal muscles respectively, and to analyze the mtDNA 4977 deleted rate of cardiac and skeletal muscle cells The q test and correlation analysis were used in this study Results The mtDNA 4977 deleted rate of rheumatic mitral stenosis was 1 18%～13 75%, and that of control group was 0～0 06%,and there was signiticant difference between them (P<0 05) The worse the cardiac function, the higher the mtDNA 4977 deleted rate Cardiac function was classified according to NYHA :grade Ⅱ(B group), Ⅲ(C group), Ⅳ(D group) Their mtDNA 4977 deleted rate were 3 79‰, 6 32‰ and 9 28‰ respectively The mtDNA 4977 deleted rate of every two grades differed significantly(P<0 05) The mtDNA 4977 deleted rate of cardiac myocytes in rheumatic mitral stenosis had a positive correlation with that of the skeletal muscle cells according to the correlation analysis(r=0 75,P<0 01) Conclusion The mtDNA 4977 deleted rate of rheumatic heart diseases has a close relation with the cardiac function disturbance mtDNA 4977 deleted rate of skeletal myocytes in the rheumatic heart diseases has a positive correlation with that of cardiac myocytes