微纤维蛋白1在瓣膜性心房颤动患者心房组织中的表达及其与心房纤维化的关系

摘要

目的: 观察微纤维蛋白1(FBN-1)在风湿性心脏瓣膜病并发心房颤动(AF)患者心房组织中的表达,探讨FBN-1与心房纤维化的关系.方法:选择因风湿性心脏瓣膜病住院并行瓣膜置换手术的患者84例,分为AF组39例和窦性心律(SR)组45例;收集整理患者的临床资料,并于手术中获取右心房组织(0.3~0.5 mm3).Masson 染色观察2组患者右心房纤维化程度;Western blotting法测定各组患者心房组织中FBN-1蛋白的表达,相关分析探讨FBN-1与心房纤维化的关系.结果: 2组患者在性别构成比、年龄、血压、血常规和生化指标等方面比较差异无统计学意义(P>0.05).AF组患者左和右心房直径明显大于SR组(P<0.05);Masson 染色,AF组患者心房组织存在明显纤维化,AF组患者胶原容积分数和胶原水平明显高于SR组(P<0.05);AF组患者心房组织中FBN-1的蛋白表达水平明显高于SR组(P<0.05);瓣膜性AF患者右心房组织FBN-1蛋白表达水平与胶原水平呈正相关关系(r=0.544, P=0.021).结论: 瓣膜性AF患者心房组织存在明显的心房纤维化,与FBN-1基因转录水平上调有关联.%Objective:To investigate the expression of fibrillin-1 (FBN-1) in the atrium tissue of the patients with rheumatic heart valve disease complicated with atrial fibrillation(AF), and to explore its relationship with atrial fibrosis in the patients with valvular atrial fibrillation.Methods:Eighty-four consecutive patients with rheumatic heart valve disease underwent cardiac surgery were enrolled in this study.The patients were divided into AF group(n=39) and sinus rhythm group(SR group, n=45).The clinical data of patients were collected before operation.The right atrium tissue (0.3-0.5 mm3) was disserted during operation.The degrees of right atrial fibrosis of the patients in two groups were observed by Masson staining.Western blotting method was used to measure the protein expressions of FBN-1 in atrium tissue of the patients in two groups.Results:There were no significant differences in the gender ratio, age, blood pressure, blood biochemical indicators and other aspects of medical history between two groups(P>0.05);the diameters of left and right atrium of the patients in AF group were significantly larger than those in SR group(P<0.05).The Masson staining results showed that there was obvious fibrosis in AF group, and the collagen volume fraction and collagen level in AF group were significantly higher than those in SR group (P<0.05).The expression level of FBN-1 in right atrium tissue in AF group was obviously higher than that in SR group(P<0.05).The expression level of FBN-1 protein in right atrium tissue of the patients with valvular atrial fibrillation was positively correlated with the collagen level(r=0.544,P=0.021).Conclusion:There is obvious atrium fibrosis in the patients with valvular atrial fibrillation;it is closely related to the up-regulation of the expression of FBN-1 gene.