先天性心脏病肺动脉高压患儿肺组织中尾加压素Ⅱ的表达及其意义

摘要

Objective To observe the expression of urotensin Ⅱ ( U Ⅱ ) on the lung of patients with pulmonary hypertension(PH) with congenital heart disease and investigate the meaning of this phenomenon.Method Thirty eight patients with CHD were divided into three groups according to pulmonary arterial systolic pressure (PASP) measured in cardiac catheterization and surgery:normal pulmonary pressure group (N group,PASP ＜30 mm Hg,n =10),mild PH group (M group,PASP≥30 mm Hg,n =15),severe or moderate PH group (S group,PASP≥50 mm Hg,n =13).The expression of U Ⅱ protein and U Ⅱ mRNA in pulmonary arterioles were measured separately by immunohistochemical (IHC) analysis and in situ hybridization (ISH) analysis.Result ( 1 ) The results of U Ⅱ IHC staining:The U Ⅱ protein expression of group M was higher than that of group N (20.22 ±3.58 vs.14.34 ±2.18,P ＜0.01 ),but less than group S (20.22 ± 3.58 vs.28.92 ± 3.22,P ＜ 0.05 ).(2) The results of U Ⅱ ISH mRNA staining were similar to IHC staining,the A value of group M was higher than group N ( 12.51 ±2.02 vs.8.85 ± 1.41,P ＜0.05),less than that of group S( 12.51 ±2.02 vs.25.35 ±4.33,P ＜0.01 ).(3) CorTelation study:there was a positive correlation between the A values of U Ⅱ IHC and pulmonary hypertension ( r =0.64,P ＜0.01,n =38),a positive correlation between the A values of U Ⅱ ISH and pulmonary hypertension ( r =0.58,P ＜0.01,n =38). Conclusion There was the expression of Urotensin Ⅱ protein and mRNA in the lung of pulmonary hypertension patients with congenital heart disease, and these expression may involve the formation of pulmonary hypertension of congenital heart disease.%目的 观察尾加压素Ⅱ在先天性心脏病肺动脉高压患儿肺组织中的表达情况,并探讨其意义.方法 收集温州医学院育英儿童医院28例先天性心脏病伴有肺动脉高压患儿及10例先天性心脏病无肺动脉高压患儿的肺组织,根据肺动脉收缩压(PASP)分为轻度肺高压组(PASP≥30mm Hg,n=15)(1 mm Hg =0.133 kPa)、中重度肺高压组(PASP≥50 mm Hg,n=13)和无肺高压组( PASP＜ 30 mm Hg,n=10),采用免疫组化及原位杂交的方法检测肺组织中的尾加压素Ⅱ蛋白及mRNA表达变化.本研究获得温州医学院附属第二医院伦理委员会审查通过,入组患儿家长或监护人均签署知情同意书.结果 (1)免疫组化显示:尾加压素Ⅱ蛋白在各组先天性心脏病患儿肺组织中均有表达.轻度肺高压组(20.22 ±3.58)、中重度肺高压组(28.92±3.22)尾加压素Ⅱ蛋白表达高于无肺高压组(14.34 ±2.18)(P均＜0.01),中重度肺高压组尾加压素Ⅱ蛋白表达高于轻度肺高压组(P＜0.05).(2)原位杂交显示:尾加压素ⅡmRNA在中重度肺高压组表达(25.35 ±4.33)明显高于轻度肺高压组(12.51 ±2.02)及无肺高压组(8.85±1.41)(P均＜0.01),轻度肺高压组尾加压素ⅡmRNA表达亦高于无肺高压组(P＜0.05).(3)相关分析显示:尾加压素Ⅱ蛋白及mRNA表达与肺动脉压力成正相关关系(r分别为0.64和0.58,P＜0.01).结论 先天性心脏病肺动脉高压患儿肺组织中存在尾加压素Ⅱ的表达,可能参与了先天性心脏病肺动脉高压的形成.