中华胸心血管外科杂志
中華胸心血管外科雜誌
중화흉심혈관외과잡지
Chinese Journal of Thoracic and Cardiovascular Surgery
2008年
4期
252-254
,共3页
梁红%LIN Han-sheng%翁渝国
樑紅%LIN Han-sheng%翁渝國
량홍%LIN Han-sheng%옹투국
心脏辅助装置%辅助循环%心肌病,扩张型%预后
心髒輔助裝置%輔助循環%心肌病,擴張型%預後
심장보조장치%보조순배%심기병,확장형%예후
Heart assist device%Assisted circulation%Cardiomyopathy,dilated%Prognosis
目的 探讨心室辅助前、后心肌胶原含量改变与预后的关系.方法 依据心室辅助后病人是否心脏移植分为移植组和撤离组,取左心室心肌行心肌胶原(Sircol法及羟脯氨酸定量)和蛋白测定,比较心室辅助前、后胶原及蛋白含量的差异与不同预后病人的关系.结果 心室辅助前,除总羟脯氨酸外,两种预后病人的胶原和蛋白质含量的差别均有统计学意义(P<0.05),撤离组明显高于移植组;撤离组蛋白质含量甚至高于移植组的辅助后测定值(P<0.05).移植组心室辅助后盐溶胶原及蛋白质和总羟脯氨酸含量较辅助前增加(P<0.05).结论 扩张性心肌病病人心肌间质重塑的含义不同,部分胶原及蛋白质含量增加可能与良好预后有关;心室辅助改善心功能的机制可能与间质胶原改变有关.
目的 探討心室輔助前、後心肌膠原含量改變與預後的關繫.方法 依據心室輔助後病人是否心髒移植分為移植組和撤離組,取左心室心肌行心肌膠原(Sircol法及羥脯氨痠定量)和蛋白測定,比較心室輔助前、後膠原及蛋白含量的差異與不同預後病人的關繫.結果 心室輔助前,除總羥脯氨痠外,兩種預後病人的膠原和蛋白質含量的差彆均有統計學意義(P<0.05),撤離組明顯高于移植組;撤離組蛋白質含量甚至高于移植組的輔助後測定值(P<0.05).移植組心室輔助後鹽溶膠原及蛋白質和總羥脯氨痠含量較輔助前增加(P<0.05).結論 擴張性心肌病病人心肌間質重塑的含義不同,部分膠原及蛋白質含量增加可能與良好預後有關;心室輔助改善心功能的機製可能與間質膠原改變有關.
목적 탐토심실보조전、후심기효원함량개변여예후적관계.방법 의거심실보조후병인시부심장이식분위이식조화철리조,취좌심실심기행심기효원(Sircol법급간포안산정량)화단백측정,비교심실보조전、후효원급단백함량적차이여불동예후병인적관계.결과 심실보조전,제총간포안산외,량충예후병인적효원화단백질함량적차별균유통계학의의(P<0.05),철리조명현고우이식조;철리조단백질함량심지고우이식조적보조후측정치(P<0.05).이식조심실보조후염용효원급단백질화총간포안산함량교보조전증가(P<0.05).결론 확장성심기병병인심기간질중소적함의불동,부분효원급단백질함량증가가능여량호예후유관;심실보조개선심공능적궤제가능여간질효원개변유관.
Objective To investigate the relation between the changes d myocardial collagen content before and after ventricu-lar assist device (LVAD) application and the prognosis in dilated cardiomyopathy. Methods Patients was divided to two groups ac-cording to the prognosis (weaning or transplantation) after LVAD application. Left ventricular samples were collected from the patients (weaning group n= 10, transplanted group n=8) at the time the LVADs were implanted, and again during cardiac transplantation ( n = 8 ). The content of neutral salt soluble collagen (NSC) and acid soluble collagen (ASC) were measured by Sired collagen assay and total collagen and insoluble collagen (ISC) by quantification of hydroxyproline. Moreover, protein quantification of each collagen fraction was performed simultaneously. Results Before LVAD implantation all collagen fraction and their protein contents were higher in the weaning group than that in the transplanted group ( P <0.05), but the difference in the collagen fraction disappeared after LVAD support. Comparison of the pre- and post-LVAD subgroups of the transplanted group showed an increase of NSC and its protein content and total hydroxyproline after LVAD support (P<0.05). Conclusion The significances of myocardial intersititial remodeling in DCM are not identical. Some myocardial collagen and protein content increases may be related to good prognosis. The mechanism of LVAD improving cardiac function may be related to the changes of myocardial intersitial collagen.
