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目的探讨心房颤动(房颤)患者心房肌组织盐皮质激素受体(MR)mRNA 和蛋白表达的改变。方法入选进行人工心脏瓣膜置换术的风湿性心脏病患者25例,其中窦性心律者(窦律组)12例,永久性房颤者(房颤组)13例(房颤时间≥6个月)。上述患者均于术前进行经胸超声心动图检查并留取有关资料,于手术时取左、右心房侧壁组织,用实时荧光定量聚合酶链反应和 Westernblot 分别测定 MR mRNA 及其蛋白在心房肌组织中的表达情况,用免疫组织化学染色检测 MR 在心房肌细胞中的分布。结果与窦律组比较,房颤组左房内径显著扩大(P<0.01);心房肌组织 MRmRNA 及其蛋白表达均明显增加(P<0.01或0.05),但在左、右心房之间无论是在窦律或房颤时 MRmRNA 及其蛋白表达差异均无统计学意义(P>0.05);免疫组织化学染色证明,MR 主要分布在心房肌细胞胞质中,且在房颤时其染色密度明显增加。结论房颤时心房肌组织 MR 表达增加,醛固酮受体拮抗剂将可能对房颤发挥治疗作用。
Objective To investigate the changes of mineralocorticoid receptor (MR) mRNA and protein expression in atrial myocardium of patients with atrial fibrillation (AF). Methods Twenty-five patients with rheumatic heart disease undergoing heart valve replacement were enrolled, including 12 patients with sinus rhythm (sinus rhythm group), 13 patients with permanent atrial fibrillation (AF group) (atrial fibrillation ≥ 6 months ). The above patients underwent transthoracic echocardiography before surgery and the relevant data were collected. The left and right atrial wall tissues were obtained during operation. Real-time quantitative PCR and Western blot were used to detect MR mRNA and protein in the atrium The expression of MR in atrial myocytes was detected by immunohistochemical staining. Results Compared with sinus rhythm group, the left atrium diameter of atrial fibrillation group was significantly increased (P <0.01); MRmRNA and its protein expression were significantly increased in atrial fibrillation group (P <0.01 or 0.05) The expression of MR mRNA and its protein in sinus rhythm or atrial fibrillation had no significant difference (P> 0.05). Immunohistochemical staining showed that MR mainly distributed in the cytoplasm of atrial myocytes and its staining density was obvious in atrial fibrillation increase. Conclusion Atrial fibrillation increased MR expression during atrial fibrillation, aldosterone receptor antagonist may play a therapeutic role in atrial fibrillation.