【摘要】 目的研究热休克蛋白72(HSP72)和诱导型一氧化氮合酶(iNOS)在慢性缺氧型及非缺氧型先天性心脏病患儿体外循环术(CPB)前后的表达及其相关性;探讨HSP72和一氧化氮(NO)对缺血缺氧心肌的作用。方法在已确诊先天性心脏病(房间隔缺损、室间隔缺损、法洛四联症)住院患儿中,随机抽取18例分为慢性缺氧组[动脉氧饱和度(SaO2)<85%]及非缺氧组(SaO2>95%),每组9例。两组分别于CPB中主动脉交叉钳夹(ACC)前、CPB结束时收集患儿心肌标本保存在液氮中。试验采用半定量逆转录聚合酶链式反应(RT-PCR)技术测定心肌细胞中HSP72和iNOSmRNA的相对含量,比较两组心肌CPB前后HSP72和iNOSmRNA水平,并分析其临床意义。结果①与CPB术前相比,非缺氧组及慢性缺氧组HSP72mRNA水平均明显增高(P<0.05);CPB术前及术后,慢性缺氧组HSP72mRNA水平均明显高于非缺氧组(P<0.05)。②与CPB前相比,非缺氧组iNOSmRNA水平明显增高(P<0.05),而慢性缺氧组iNOSmRNA水平无明显变化(P=0.795);CPB术前及术后,慢性缺氧组iNOSmRNA水平均明显高于非缺氧组(P<0.05)。结论缺血应激上调了非缺氧型先天性心脏病患儿心肌组织HSP72、iNOS及慢性缺氧型先天性心脏病患儿心肌组织HSP72的基因表达,慢性缺氧应激也上调了慢性缺氧型先天性心脏病患儿心肌组织HSP72、iNOS的基因更多还原

【Abstract】 Objective To investigate mRNA expression of heat shock protein72 (HSP72) and inducible nitric oxide synthase (iNOS) chronically hypoxic and normoxie infant human in myocardium before and after cardiopulmonary bypass(CPB). Methods The levels of HSP72 mRNA and iNOS mRNA were compared in the cardiac tissue from right atrium of patients before and after cardiopulmonary bypass surgery for correction of congenital heart disease (n=18). HSP72 mRNA and iNOS mRNA expression were evaluated in pre- and post-CPB by semi-quantitative RT-PCR. Results ①HSP72 mRNA levels increased after CPB in all chronically hypoxic and nomoxic hearts(P<0.05), and also increased in chronically hearts compared with nomoxic hearts(P<0.05). ②iNOS mRNA levels increased after CPB in patients with normoxic congenital heart defects(P<0.05), but no remarkable variety in chronically hearts(P=0.795). Conclusion In ischemic condition, HSP72 and iNOS gene expression increased in cardiac tissue from patients with nomoxic congenital heart defects and HSP72 in chronically hypoxic hearts, and chronic hypoxia also upregulates HSP72 and iNOS gene expression in chronically hypoxic hearts. In ischemic condition, iNOS gene expression has not notable variety in chronically hypoxic hearts.更多还原