目的:探讨实验性自身免疫性心肌炎(EAM)大鼠血清透明质酸(HA)和层黏连蛋白(LN)的动态变化及其意义.方法:Lewis大鼠60只,随机等分为6组,其中5组采用心肌C蛋白和完全弗氏佐剂足底注射,百日咳毒索腹腔内注射制作EAM大鼠模型.在免疫注射后1w、2w、4w、6w和8w,取心脏,行苏木索-伊红染色检测心肌炎症积分,天狼星红染色检测心肌纤维化积分,同时行放射免疫分析检测血清HA和LN.另外1组不予免疫注射,作为空白组.结果:EAM大鼠心肌炎症积分在免疫注射后1w较空白组大鼠无明显改变,2w后迅速升高,高水平状态维持到第4w,以后逐渐下降;心肌间质纤维化积分在免疫注射后第1w、2w较空白组大鼠无明显改变,第4w后迅速升高,并维持高水平状态到第8w;血清HA和LN在免疫注射后第1w、2w水平较空白组大鼠无明显改变,第4w迅速升高,并维持高水平状态到第8w,同心肌间质纤维化积分变化一致.结论:血清HA和LN水平可作为判断心肌自身免疫性心肌炎心肌间质纤维化程度和活动性,且能作为预测心脏病转归方向的指标.%Objective To study the clinical significance of dynamic changes of serum expressions of hyaluronic acid (HA) and laminin (LN) in Lewis rat models of experimental autoimmune myocarditis (EAM). Methods Fifty Lewis rat models of experimantal autoimmune myocarditis (EAM) were established with injection of recombinant cardiac C protein with complete freund adjuvant into two foot-pads plus intraperitoneal injection of pertussis toxin. At 1w, 2w, 4w, 6w and 8w, 10 models were sacrificied each time: cardiac tissues were examined with HE stain for myocardial inflammatory acore and examined with picresirius red stain for myocardial fibro sis score, also, serum HA and LN expressions were determined with RIA. These examinations were performed in 10 undisturbed animals as controls. Results The myocardial inflammatory scores of the models at 1 w were about the same as those in the controls, but the scores rapidly increased from 2w on to 4w then fell gradually. The myocardial fibrosis scores of the models at 1wk were also not much different from those in controls. The fibrosis scores increased rapidly at 4w and maintained at high level up to 8w. The changes of serum expressions fo HA and LN roughly paralleled those of myocardial fibrosis scores i.e. rapidly increased at 4w up to 8w. Conclusion Serum expressions of HA and LN could faithfully reflect the degree of myocardial fibrosis in rat models of EAM. HA and LN were useful markers of myocardial fibrois and were of prognostic importance.
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