论文部分内容阅读
目的 探讨心房颤动(简称房颤)患者KLOTHO基因的表达及其与纤维化的相关性.方法 60例行心脏手术患者按心脏节律分为窦性心律组、阵发性房颤组及持续性房颤动,每组20例.采用用实时荧光定量聚合酶链式反应的方法研究KLOTHO基因mRNA在患者心房肌组织中的表达,及其与血清中心肌纤维化指标Ⅰ型前胶原羧基端肽(PⅠ CP)、Ⅲ型前胶原氨基端肽(PⅢNP)的关系.并行心肌组织切片HE染色来观察心肌纤维化的程度.结果 ①与窦性心律组相比,房颤组左房明显扩大(P＜0.05),持续性房颤组的左房内径大于阵发性房颤组(P＜0.05).②与窦性心律组相比,阵发性房颤、持续性房颤组心房组织的KLOTHO mRNA水平均明显减少(P＜0.05);持续性房颤组KLOTHO mRNA表达较阵发性房颤组亦明显减少(P＜0.01).③窦性心律组心肌间质中仅见极少量胶原纤维;阵发性房颤组心肌间质中胶原沉积增多,心肌肌束周围可见明显胶原纤维包绕;持续性房颤组心肌间质中纤维组织显著增生,心肌肌束被大量的条索状胶原纤维所分隔.④与窦性心律组相比,房颤组血清PⅠ CP、PⅢNP含量明显增高(P＜0.01),且持续性房颤组PⅠ CP、PⅢNP含量较阵发性房颤组明显增加(P＜0.05);⑤房颤患者心肌KLOTHO mRNA水平与左房内径、血清中PⅠ CP、PⅢNP呈独立的、显著的负相关关系(P＜0.01).结论 房颤患者KLOTHO基因的表达增加,心肌纤维化的程度减少,提示KLOTHO基因可能与心房纤维化有关.“,”Objective Investigate KLOTHO gene expression in patients with atrial fibrillation(AF) and its correlation with fibrosis.Methods Sixty patients undergone cardiac surgery were divided into three groups according to the heart rhythm:sinus rhythm group,persistent AF and paraxysmal AF group.Each group has 20 patients.The mRNA amounts of Klotho gene were studied by real time quantitative polymerase chain reaction(RT-PCR) method with the right atrial tissues of AF.And to study the correlation to P Ⅰ CP,PⅢ NP in serum,which are myocardial fibrosis signal.Myocardial tissue HE staining to observe the extent of myocardial fibrosis.Results ①Left atrial diameter were significantly increased in patients with AF(P＜0.05).Which persistent AF group higher than paroxysmal AF group (P ＜ 0.05);② The mRNA level of KLOTHO significantly decreased in both paroxysmal AF and persistent AF groups compared with the sinus rhythm group(P＜0.05;P＜0.05) and the persistent AF group was lower than paroxysmal AF groups (P＜0.01);③There was very few collagen fiber in myocardial stroma in sinus rhythm group;Myocardial stroma collagen deposition multiplied in paroxysmal AF group,apparent collagen fiber around cardiac muscle bundle;Myocardial stroma fibrous tissue remarkable hyperplasia in persistent AF group,and cardiac muscle bundle was spaced by the amount of the bands of collagen fiber;④Compared with the sinus rhythm group,the significant increase was observed in the persistent AF compared with paroxysmal AF groups in the concentrations of serum P Ⅰ CP,PⅢ NP (P＜0.01)and the persistent AF group was higher than paroxysmal AF groups(P＜0.05);⑤There was a conspicuous and independent negative correlation between the expression of KLOTHO mRNA and the P 1 CP,PⅢ NP and left atrial diameter(P＜0.01).Conclusions The KLOTHO gene m-RNA level is decreased in AF,and the degree of myocardial fibrosis is increased,it indicates the KLOTHO gene may be involved in atrial remodeling.