【摘要】 探讨风湿性心脏病 (简称风心病 )心房颤动 (简称房颤 )患者心房组织细胞外信号调节激酶 (ERK)与心房纤维化的关系。 33例风心病二尖瓣病变患者行心脏外科手术时取右心耳组织。通过逆转录 聚合酶链反应和免疫组织化学技术 ,测量ERK2 mRNA和激活的ERK2 蛋白相对表达量 ,测定心房组织血管紧张素Ⅱ (AngⅡ )含量和胶原纤维容积分数 (CVF)。结果 :阵发性和慢性房颤患者的心房组织CVF、AngⅡ均明显高于窦性心律患者 (10 .4 4 %±1.83% ,15 .0 1%± 2 .30 %vs 7.4 8%± 1.2 6 % ;10 .17± 1.73,12 .13± 1.95vs 6 .6 9± 1.18ng/mg,P均 <0 .0 1) ,而慢性房颤患者的CVF、AngⅡ又明显高于阵发性房颤患者 (P <0 .0 1,P <0 .0 5 ) ;阵发性和慢性房颤患者的心房组织ERK2mRNA表达量显著高于窦性心律患者 (1.2 0 9± 0 .2 85 ,1.30 5± 0 .2 6 3vs 0 .92 3± 0 .2 71;P <0 .0 5 ,P <0 .0 1) ,而阵发性和慢性房颤患者之间无明显差别 (P >0 .0 5 ) ;阵发性和慢性房颤患者的心房间质细胞激活的ERK2 蛋白表达量显著高于窦性心律患者 (0 .2 5 2± 0 .0 75 ,0 .2 88± 0 .0 6 3vs 0 .175± 0 .0 74 ;P均 <0 .0 1) ,而阵发性和慢性房颤患者之间无明显差别 (P >0 .0 5 )。结论 :心房间质ERK途径的激活是风心病房颤患者心房纤维更多还原

【Abstract】 Department of Cardiology,Renmin Hospital of Wuhan University,Wuhan 430060,ChinaTo study the relationship between extracellular signal regulated kinase (ERK) and atrial fibrosis in patients with rheumatic heart disease(RHD) and atrial fibrillation(AF),atrial tissue was obtained from the right atrial appendage during open heart surgery in 33 patients with RHD.ERK 2 mRNA and activated ERK 2 were semi quantified by reverse transcription polymerase chain reaction and immunohistochemistry.The content of atrial tissue angiotensinⅡ(AngⅡ) and atrial collagen volume fraction(CVF) were analyzed respectively by radioimmunoassay and histochemistry.Results:The atrial CVF and AngⅡ content of patients with paroxysmal AF or chronic AF were significantly increased compared with patients in sinus rhythm (10.44%±1.83%,15.01%±2.30% vs 7.48%±1.26%;10.17±1.73, 12.13 ±1.95 vs 6.69±1.18 ng/mg, P all<0.01),and the atrial CVF and AngⅡ content of patients with chronic AF were significantly increased compared with patients with paroxysmal AF( P<0.01,P <0.05).The mRNA of ERK 2 in patients with paroxysmal AF or chronic AF was significantly higher than that in patients with sinus rhythm (1.209±0.285,1.305±0.263 vs 0.923±0.271, P <0.05, P <0.01),no difference between paroxysmal AF and chronic AF( P >0.05).The protein of activated ERK 2 in atrial interstial cells of patients with paroxysmal AF or chronic AF was significantly increased compared with patients in sinus rhythm (0.252±0.075,0.288±0.063 vs 0.175±0.074, P all<0.01),there was no significantly difference between paroxysmal AF and persistent AF( P >0.05).Conclusions:An increase in the amounts of activated ERK in atrial interstial cells may contribute as a molecular mechanism for the development of atrial fibrosis in patients with RHD and AF.Atrial fibrillation更多还原