张军波,吕颖,刘仲伟,潘军强,殷艳蓉
ZHANG Junbo,LV Ying,LIU Zhongwei,PAN Junqiang,YIN Yanrong

• 1:西安交通大学第一附属医院周围血管科
• 2:西安交通大学第三附属医院&陕西省人民医院心内科
• 3:西安交通大学第一附属医院心血管内科

摘要(Abstract)：

目的:探讨瓣膜性房颤(AF)患者心房纤维化及心房组织局部过氧化物酶体增殖物激活受体α(PPARα)mRNA表达。方法:选取81例接受人工心脏瓣膜置换术的风湿性心脏瓣膜病患者术中废弃的右心房右心耳组织分为AF组(n=38)和窦性心律组(n=41),分别采用HE染色及Masson染色观察2组患者心房组织纤维化情况,采用Realtime-PCR测定心房组织中PPARα mRNA表达。结果:染色结果显示,AF组患者心房组织纤维化较窦性心律组加重,HE染色可见AF组患者右心房组织结构明显紊乱、心肌细胞肥大、排列不匀、组织间空隙较多、细胞核浓染、大小不一、细胞间隙可见明显纤维组织增生,Masson染色可见AF组心房肌细胞肥大、排列较稀疏、可见蓝色胶原纤维组织分割包绕褐色的心房肌细胞,细胞间间隙增大,其中蓝色胶原纤维组织较窦性心律的患者明显增多;Realtime-PCR结果显示, AF组患者右心房组织PPARα mRNA表达水平较窦性心律组明显下降,差异有统计学意义(P<0.05)。结论:瓣膜性AF患者的心房组织纤维化明显加重,可能与心房组织的PPARα表达下降有关。
Objective: To investigate atrial fibrosis(AF) in patients with valvular atrial fibrillation and expression of local PPARα mRNA. Methods: 81 patients with rheumatic heart valve replacement were chosen, and they were divided into the discarded right atrial and right auricle tissues atrial fibrillation group(AF group, n=38) and sinus rhythm group(n=41). The atrial fibrosis of both groups was observed by HE staining and Mason staining, and the expression of PPARα in the atrial tissues were measured by Real time-PCR. Results: Staining results showed that the atrial fibrosis in patients with valvular atrial fibrillation was more serious than that in patients with sinus rhythm. Meanwhile, HE staining indicated that structure of right atrial tissue of AF group with following features: disordered, poorly arranged with multiple gaps among the tissues, nucleus hyperchromia, anisocytosis, cardiomyocyte hypertrophy, intercellular space with obvious proliferation of fibrous tissue; Masson staining indicated that AF group with following features: cardiomyocyte hypertrophy, sparse arrangement, blue fibrous collagen divide and wrap the atrial myocyte, intercellular space was enlarged; of which blue fibrous collagen was significantly increased than sinus rhythm group patients; Real time-PCR showed that the expression of PPARα mRNA was significantly lowered in patients with valvular atrial fibrillation than that in patients with sinus rhythm, differences was statistically significant(P<0.05). Conclusion: The atrial fibrosis in patients with valvular atrial fibrillation was significantly aggravated. It is suggested that the decrease of PPARα may be related to it.

关键词(KeyWords)： 心房颤动;风湿性心脏病;右心房;心肌纤维化;过氧化物酶体增殖物激活受体
atrial fibrillation;rheumatic heart disease;right atrium;myocardial fibrosis;peroxisome proliferators-activated receptor

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金项目(81600646)

作者(Author): 张军波,吕颖,刘仲伟,潘军强,殷艳蓉
ZHANG Junbo,LV Ying,LIU Zhongwei,PAN Junqiang,YIN Yanrong

DOI: 10.19367/j.cnki.1000-2707.2019.11.007

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