CAJ | 학술논문

目的：探讨心脏瓣膜病患者心肌组织脂联素抵抗及其相关机制。方法选择行体外循环下瓣膜置换手术的心脏瓣膜病患者36例为观察组，心脏移植捐献者及心脏外伤需手术患者22例为对照组。两组均手术中体外循环建立时剪除心肌组织，用RT-PCR法检测脂联素表达，Western Blot法检测脂联素下游通路重要分子腺苷酸活化蛋白激酶（ AMPK）活性，HE染色观察心肌组织病理情况。结果与对照组相比，观察组心肌组织脂联素mRNA表达显著升高，AMPK活性显著降低，P均＜0．05。心肌组织病理改变与相应心功能特点相符。结论心脏瓣膜病患者心肌组织脂联素水平显著升高，脂联素受体后AMPK磷酸化水平降低导致脂联素无法发挥正常的心肌保护效应，心脏瓣膜病患者的心肌组织出现脂联素抵抗。
목적：탐토심장판막병환자심기조직지련소저항급기상관궤제。방법선택행체외순배하판막치환수술적심장판막병환자36례위관찰조，심장이식연헌자급심장외상수수술환자22례위대조조。량조균수술중체외순배건립시전제심기조직，용RT-PCR법검측지련소표체，Western Blot법검측지련소하유통로중요분자선감산활화단백격매（ AMPK）활성，HE염색관찰심기조직병리정황。결과여대조조상비，관찰조심기조직지련소mRNA표체현저승고，AMPK활성현저강저，P균＜0．05。심기조직병리개변여상응심공능특점상부。결론심장판막병환자심기조직지련소수평현저승고，지련소수체후AMPK린산화수평강저도치지련소무법발휘정상적심기보호효응，심장판막병환자적심기조직출현지련소저항。
Objective To investigate the effect of adiponectin resistance on heart valve disease and the related resist -ance mechanism .Methods Thirty-six patients undergoing cardiopulmonary bypass ( CPB) heart valve replacement surger-y ( the treatment group ) and 22 cases of heart transplant donors who needed heart surgery ( the control group ) were select-ed.The myocardial tissues which were cut off in the cardiac operation under CPB were collected .The adiponectin expres-sion in the myocardial tissue samples was detected by RT-PCR.The adiponectin important molecular pathways downstream AMP-activated protein kinase ( AMPK) activity was detected by Western blotting .The cardiac pathology was detected by HE staining method.Results Compared with the control group , adiponectin mRNA was significantly higher , and the level of downstream pathways AMPK phosphorylation was significantly lower in the treatment group (all P<0.01).Histopathol-ogy results complied with the appropriate cardiac function of myocardial performance .Conclusion The adiponectin levels in the tissues of patients with heart valve disease are significantly increased , but adiponectin receptor AMP-activated protein kinase ( AMPK) phosphorylation levels are decreased , thus adiponectin can not play the protective effect , and myocardial tissues of patients show adiponectin resistance .