心脏术后细菌感染左右心室组织细胞粘附分子和炎症细胞因子基因比较表达

目的为了解细菌感染性心内膜炎在左右心脏的明显不同临床发病率的原因,研究二尖瓣,三尖辩外科手术和金葡菌菌血症后左右心脏组织部分细胞粘附分子和炎症细胞因子的基因的变化.方法26只家兔分别行二尖瓣,三尖瓣手术和经静脉注射金葡菌,术后早期提取左右心室组织RNA,应用RT-PCR技术检测内皮白细胞粘附分子(ELAM-1),巨噬细胞集落刺激因子(MCSF-1)和血小板内皮细胞粘附分子(PECAM-1)基因表达水平的变化.结果左右心室组织的ELAM-1和MCSF-1在二尖瓣和三尖瓣手术后均明显的高表达,左室表达水平高于右室;PECAM-1没有明显的变化.单独注射金葡菌后仅左心室ELAM-1表达水平与对照组相比明显升高.结论感染性心内膜炎的进程中左右心室组织的细胞粘附分子和炎症因子存在着不同的变化特点.

Gene expression of cell adhesion molecules and inflammatory mediator after operation and staphylococcus aureus bacteremia on rabbit heart

Objective] There is significant difference in the incidence of left and right infective endocarditis. To obtain a better insight into the molecular pathology of them, this paper studied left and right ventericle cell adhesion molecules and inflammatory mediators's mRNAs expression in rabbits after mitral or tricuspid valve surgery and S.aureus bacteremia. Methods] 26 rabbits received 5×106 colony forming units Staphylococcus aureus i.v.; or underwent mitral surgery/tricuspid surgery respectively. The hearts were explanted 24 hours after the intervention, total RNAs of left or right ventricles were isolated and mRNA abundance determined by semiquantitative duplex RT-PCR using 18S RNA as internal control. Results were compared to the control group consisting of seven untreated rabbits.Results] S. aureus bacteremia alone did only lead to significantly changed mRNA levels of ELAM-1 in left ventericles. After mitral and tricuspid valve surgery, ELAM-1 and MCSF-1 mRNA expressions in left and right ventricles were significantly upregulated, their levels in left ventricle were higher than those in right ventricles. Conclusions ]There are different changes of cell adhesion moleculers and inflammatory mediators in left and right ventricles in the development of infective endocarditis.