摘要
目的 研究风湿性心脏病二尖瓣和主动脉瓣瓣膜胶原含量及其类型对瓣膜成形术病例选择的影响。方法 采用羟脯氨酸法测定瓣膜胶原含量的变化 ,并用十二烷基磺酸钠 -聚丙烯酰胺凝胶电泳 (SDS- PAGE)分离法测定心瓣膜胶原的类型。 结果 正常二尖瓣腱索的胶原含量较瓣叶高 (P<0 .0 1) ,主动脉瓣胶原含量较二尖瓣低 (P<0 .0 1)。风湿性心脏病患者二尖瓣和主动脉瓣的胶原含量较正常瓣膜有显著升高 (P<0 .0 1)。正常瓣膜以 型胶原为主 , 型胶原含量较少 ,而病变二尖瓣和主动脉瓣其 型、 型胶原均明显增加 ,且以 型胶原为主。有钙化的二尖瓣腱索胶原含量高于无钙化瓣膜 (P<0 .0 5 )。二尖瓣病变以狭窄为主的病例其二尖瓣腱索的胶原含量较以关闭不全为主的病例高 (P<0 .0 1) ,且二尖瓣瓣叶及腱索的胶原含量与二尖瓣口面积呈负相关 (r=- 0 .5 431和 r=- 0 .8819,P<0 .0 1)。 结论 风湿性心脏病心瓣膜胶原含量和类型的变化与心瓣膜功能的改变密切相关 ,瓣膜有无钙化以及二尖瓣病变的性质 。
Objective To Study the content and types of collagen in patient with rheumatic heart disease (RHD), and discuss the index of valvuloplasty and valve replacement. Methods The content of collagen of the valve was measured and the types of collagen were analyzed by SDS-polyacrylamide gel electrophoresis. Results In mitral valve of controls, the content of collagen in cordae tendon was higher than that in the leaf (P<0.01), and mitral valve had more collagen as compared with aortic valve (P<0.01). Type Ⅰ collagen was dominant in normal valve as compared with type Ⅲ. In RHD patients, the collagen content in mitral valve and aortic valve was much high than the controls (P<0.01). Both type Ⅰ and Ⅲcollagen increased markedly in RHD patients, and type Ⅰ collagen was dominant. The collagen content in mitral valve with calcification was higher than that of the valve without calcification (P<0.01). The collagen content in mitral valve stenosis was higher than that of insufficiency (P<0.01), and negative relationships were found between the collagen content and the area of the orifice of mitral valve (r=-0.5431 and r=-0.8819, P<0.01). Conclusion The changes of collagen content and the types of collagen is one of the main causes to valvular dysfunction in RHD. The calcification and pathological changes of the mitral valve should be evaluated cautiously before valvuloplasty was executed.
出处
《中国胸心血管外科临床杂志》
CAS
2001年第2期85-88,共4页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
关键词
风湿性心脏病
二尖瓣
主动脉瓣
胶原
Rheumatic heart disease
Mitral valve
Aortic valve
Collagen
