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目的探讨细胞凋亡及结构蛋白Ｄｅｓｍｉｎ异常表达与亚急型、慢型克山病的关系。方法应用原位末端标记法（ＴＵＮＥＬ）及免疫组化技术在亚急型和慢型克山病患者心肌石蜡包埋组织切片上进行细胞凋亡及Ｄｅｓｍｉｎ双重荧光染色，并应用共聚焦显微镜观察结果。结果克山病患者心肌组织中可见结构蛋白Ｄｅｓｍｉｎ的异常荧光染色及细胞凋亡，有Ｄｅｓｍｉｎ荧光染色变浅甚至消失，慢型克山病多表现为染色增强，或呈团状聚集于心肌细胞中间，或呈块状附于细胞膜下。凋亡细胞多见于有Ｄｅｓｍｉｎ异常改变的心肌细胞、浸润的炎细胞、血管内皮细胞及一些间质细胞。结论细胞凋亡与结构蛋白Ｄｅｓｍｉｎ异常参与克山病的发生与发展。
Objective To investigate the relationship between apoptosis and the expression of structural protein Desmin and subacute and chronic Keshan disease. Methods TUNEL and immunohistochemistry were used to detect apoptosis and Desmin double staining on myocardial paraffin embedded tissue sections of patients with subacute and chronic Keshan disease. The results of confocal microscopy . Results The aberrant fluorescence staining and apoptosis of Desmin were observed in myocardial tissue of Kershan disease. Desmin fluorescence staining became lighter or even disappeared. Slow keshanosis showed more staining, or clustered in the middle of myocardial cells , Or block attached to the cell membrane. Apoptotic cells more common in Desmin abnormal changes in myocardial cells, infiltrating inflammatory cells, vascular endothelial cells and some of the stromal cells. Conclusion The apoptosis and structural protein Desmin are involved in the occurrence and development of Keshan disease.