CAJ | 학술논문

目的：检测风湿性心脏病心房颤动（房颤，AF）患者左房心肌细胞中钙蛋白酶-2（calpain-2）的表达水平及左房心肌细胞凋亡的发生率，探讨二者之间的关系和在AF发病机制中的作用。方法选择行外科心脏瓣膜置换手术的风湿性心脏病患者47例，分为窦性心律（ NSR）组（20例）和心房颤动（ AF）组（27例）。应用荧光实时定量PCR和免疫组织化学法半定量检测calpain-2的表达；利用TUNEL法检测各组患者左房心肌细胞凋亡率。计算其凋亡指数（ AI），应用相关性分析分别分析其与前两者之间的关系。结果 AF组中calpain-2 mRNA[deltaCt值：（0．088±0．033）vs（0．065±0．020），P＜0．05]及蛋白表达量[平均光密度值：（0．091±0．017）vs（0．062±0．007），P＜0．01]及细胞凋亡水平[凋亡指数AI：（0．317±0．058）vs（0．131±0．069），P＜0．01]明显高于NSR组，AF组calpain-2的mRNA转录水平与心房肌细胞凋亡率呈明显正相关（r＝0．688，P＜0．01），calpain-2的蛋白含量与心房肌细胞凋亡呈明显正相关（ r＝0．801，P＜0．01）。结论风湿性心房颤动患者左房心肌细胞calpain-2蛋白的表达水平增高，细胞凋亡率升高，两者可能互相影响，致使心房重构，进而推动房颤的发生，可能是心房颤动形成的重要机制之一。
목적：검측풍습성심장병심방전동（방전，AF）환자좌방심기세포중개단백매-2（calpain-2）적표체수평급좌방심기세포조망적발생솔，탐토이자지간적관계화재AF발병궤제중적작용。방법선택행외과심장판막치환수술적풍습성심장병환자47례，분위두성심률（ NSR）조（20례）화심방전동（ AF）조（27례）。응용형광실시정량PCR화면역조직화학법반정량검측calpain-2적표체；이용TUNEL법검측각조환자좌방심기세포조망솔。계산기조망지수（ AI），응용상관성분석분별분석기여전량자지간적관계。결과 AF조중calpain-2 mRNA[deltaCt치：（0．088±0．033）vs（0．065±0．020），P＜0．05]급단백표체량[평균광밀도치：（0．091±0．017）vs（0．062±0．007），P＜0．01]급세포조망수평[조망지수AI：（0．317±0．058）vs（0．131±0．069），P＜0．01]명현고우NSR조，AF조calpain-2적mRNA전록수평여심방기세포조망솔정명현정상관（r＝0．688，P＜0．01），calpain-2적단백함량여심방기세포조망정명현정상관（ r＝0．801，P＜0．01）。결론풍습성심방전동환자좌방심기세포calpain-2단백적표체수평증고，세포조망솔승고，량자가능호상영향，치사심방중구，진이추동방전적발생，가능시심방전동형성적중요궤제지일。
Objective To detect the expression of calpain-2 and apoptosis in the left atria of patients with rheumatic heart disease and to find the relationship between them.Also,it was intended to investigate the effect of the calpain-2 on the mechanism of atrial fibrillation.Methods Forty-seven patients with rheumatic heat disease undergoing valve-replacement were included,27patients with atrial fibrillation,20 with regular sinus rhythm.The expression of cal-pain-2 and the mRNA of calpain-2 were detected by LSAB immunohistochemica and the Real-time PCR technology.The apoptosis index(AI) was measured by TUNEL.Results The deltaCt of calpain-2 mRNA in group AF(0.088 ±0.033) was higher than that of group NSR(0.065 ±0.020)(P<0.05).The acerage optical density values of calpain-2 of the group AF and group NSR were (0.091 ±0.017) and (0.062 ±0.007),P<0.01.AI in group AF was higher than that in group NSR (0.317 ±0.058) vs (0.131 ±0.069),P<0.01.In group AF,the levels of calpain-2 mRNA and cal-pain-2 were positively relative to AI(r=0.688,P<0.01)(r=0.801,P<0.01).Conclusion Apoptosis of atrial cell and calpain-2 increased during AF in RHD patients.And they may cause the structural remodeling and dysfunction of at-ria.The course may play a significant role in promoting the onset and maintenance of AF.