高血压心肌肥厚患者心脏交感神经分布与勿动蛋白A表达变化的关系

摘要

目的 探讨高血压心肌肥厚患者心脏交感神经分布与神经元轴突生长抑制因子勿动蛋白A(neurite outgrowth inhibitor-A,Nogo A)的表达变化.方法 从我院老年患者尸体标本库中,随机入选男性高血压患者10例,并根据患者去世前1周心脏超声结果分为心肌肥厚组4例和非心肌肥厚组6例.检测超声心动图,并计算左心室重量指数.免疫组织化学分析测定酪氨酸羟化酶(tyrosine hydroxylase,TH)与Nogo A的表达.结果 与非心肌肥厚组比较,心肌肥厚组患者室间隔厚度、左心室后壁厚度、左心室重量指数明显升高(P＜0.05)；心肌肥厚组患者心肌TH阳性表达明显降低[(6.35±3.85)％ vs(22.17±8.19)％,P＜0.05],Nogo-A表达明显增加[(11.34±7.16)％ vs(2.17±4.10)％,P＜0.05].心肌肥厚患者心肌Nogo A表达与心肌TH表达呈负相关(r=-0.33,P＜0.05).结论 老年高血压心肌肥厚患者心肌交感神经分布减低,然而心肌神经元轴突生长抑制因子Nogo-A表达增加,两者间存在密切相关性.%Objectives To investigate the relationship of cardiac sympathetic nerve distribution with expression of neurite outgrowth inhibitor-A ( Nogo-A) in elderly males with hypertension and cardiac hypertorphy. Methods Heart structure and function were measured with ultrasonic cardiogrphy,and left ventricular mass index was calculated. The expressions of tyrosine hydroxy-lase and Nogo-A were semi-quantitatively assessed with immunohistochemistry. Results As compared with the patients with hypertension but no cardiac hypertrophy,all the ventricular septum, posterior left ventricular wall and left ventricular mass index were increased (P<0. 05),the expression of tyrosine hydroxylase was reduced [(6. 35 + 3. 85)% vs (22. 17 + 8. 19)%,P<0. 05] and the Nogo-A expression was increased [(11.34 + 7. 16)% vs (2. 17 + 4. 10) % ,P<0. 05]. Correlation analysis showed that the expression of tyrosine hydroxylase was negatinvely related to the Nogo-A expression(r= -0. 33,P<0. 05). Conclusions The cardiac sympathetic nerve distribution was reduced, however, the Nogo-A expression was increased in elderly males with hypertension and cardiac hypertorphy. The Nogo-A expression is closely related to cardiac sympathetic nerve distribution.