摘要
目的 研究扩张型心肌病 (DCM)的心肌细胞凋亡及其与心功能的关系。方法 DCM组2 1例 ,其心肌组织 14例来自右室心内膜心肌活检 (EMB)亚组 ,7例来自死后尸检 (尸检亚组 ) ;对照组为 5例死于非心血管疾病的尸检心肌组织。用原位细胞凋亡法检测心肌组织凋亡细胞 ,计算凋亡指数 (AI)。结果 (1)DCM组的AI明显高于正常组 (P <0 0 1) ,EMB亚组的AI明显低于尸检亚组 (P <0 0 1) ,但明显高于对照组 (P <0 0 1)。 (2 )DCM组中 ,心胸比 (HTR) <0 6、左室舒张末期内径 (LVDd)<6 5mm和左室射血分数 (LVEF)≥ 40 %的患者AI均分别明显低于HTR≥ 0 6、LVDd≥ 6 5mm和LVEF<40 %的患者 (P值均 <0 0 1) ,但仍分别显著高于对照组 (P值均 <0 0 1)。结论 DCM存在明显心肌细胞凋亡并随心功能恶化而程度加重 ,提示凋亡是DCM的心肌细胞丢失和心功能不全的重要机制。
Objective To study apoptosis of myocardial cells in dilated cardiomyopathy (DCM) and its relation with cardiac function. Methods Myocardial samples of 21 patients in a DCM group were obtained from hearts of 14 patients undergoing endomyocardial biopsy (EMB) in right ventricular (EMB sub group) and from the hearts of the 7 remaining patients at autopsy (Autopsy sub group). Myocardial samples of a control group were obtained from hearts of 5 patients at autopsy, who died of causes other than cardiovascular disease. Apoptosis was evaluted histochemically by in situ end labeled DNA (Tunel method). Results (1) Apoptotic index (AI) of the DCM group was significantly higher than that of the control group( P <0.01), AI of EMB sub group was significantly lower than that of autopsy sub group ( P <0.01), but significantly higher than that of the control group ( P <0.01). (2) AI in patients with heart thorax ratio (HTR) <0.6, left ventricular end diastolic diameter (LVDd)<65 mm and left ventricular ejection fraction (LVEF)≥40% was significantly lower than that of patients with HTR≥0.6, LVDd≥65 mm and LVEF<40% respectively ( P <0.01 for all ),but was significantly higher than that of the control group respectively ( P <0.01 for all). Conclusions Apoptotic myocardial cells were frequently observed in the myocardial tissues of the DCM and the magnitude of apoptosis increased with the deterioration of cardiac function, indicating that apoptosis may be an important mechanism of loss of myocardial cells and cardiac dysfunction in the DCM.
出处
《中华内科杂志》
CAS
CSCD
北大核心
2001年第9期602-604,共3页
Chinese Journal of Internal Medicine
基金
广西壮族自治区卫生厅科研项目基金资助 ( 970 1)
