共聚焦显微镜检测扩张型心肌病患者心肌连接蛋白43表达的研究

目的探讨激光扫描共聚焦显微镜（LSCM）检测晚期扩张型心肌病（DCM）患者经心脏移植手术切除的心肌连接蛋白43（Cx43）表达变化及其意义。方法应用冰冻切片、免疫荧光和LSCM等技术，对3例DCM和1例室间隔缺损（对照组A）患者经心脏移植手术切除的心脏及3例颅脑损伤死者（对照组B）心肌Cx43蛋白表达情况进行定位和定量研究。结果心肌Cx43在镜下呈斑点状翠绿色荧光，DCM患者阳性着色斑点大小不一、强度不等、分布不均；对照组A阳性着色也呈大小不一的斑点状，但较DCM患者的斑点小，无明显强弱变化；对照组B阳性着色斑点分布较规则，大小及强弱较一致。定量检测发现DCM组与对照组B相比，差异有统计学意义（P〈0．01）；心脏移植患者（DCM组和对照组A）与颅脑损伤死者（对照组B）相比，差异有统计学意义（P〈0．05）；而对照组A与B相比，差异无统计学意义（P〉0．05）；各组病例左、右心室的差异无统计学意义（P〉0．05）。结论晚期DCM患者心肌Cx43蛋白表达的着色斑点大小不一、强度不等、分布不均，定量高于对照组；这些数量、强弱和分布的变化，很可能是DCM患者发生心律失常和心功能衰竭的病理基础。LSCM技术与免疫荧光技术相结合，能进行定位定量研究，较普通免疫组化更准确可靠。

Myocardial connexin 43 expression detected by LSCM in the patients with serious dilated cardiomyopathy

Objective To explore change of myocardial eonnexin43 （Cx43） expression detected by laser scanning focus on the microscope （LSCM） in the patients with serious dilated cardiomyopathy （DCM）. Methods The frozen tissue slices, immunofluoreseenee and LSCM were used to detect quantitatively the change of Cx43 expression in the myocardium of 3 patients with serious DCM and 1 patients with ventrieular septal defect who experienced heart transplantation（control group A） and 3 autopsied eases died of cranio-cerebral injury. Results Myocardial Cx43 expression was stained as emerald under microscope. The stained spots in DCM group were in different size and degree and distributed disparity. The stained spots in control group A were also in different size and degree, but the spots were smaller than DCM group, and without changes of different degree. The stain spots in control group B distributed regularly with the same size and degree. The result of myocardial Cx43 expression detected quantitatively： The difference between DCM group and control group B was significance （P〈0.01）. There was difference between patients with heart transplantation, including DCM group and control group A, and control group B （P〈0.05） which was autopsied eases who died of eranio-eerebral injury. But there were no difference between control group A and control group B and between the left ventricle and right ventricle in each group （P〉 0.05 ）. Conclusion The positive stain spots of Cx43 expression in myocardium of patients with DCM are in different sizes and degrees, distributed disparity, the amount of Cx43 expression was more than control group. The changes of myocardial Cx43 expression in different size, degree and distribution are possible pathological bases of arrhythmia and heart failure happening in patients with severe DCM. In combination with LSCM can detect the amount and position of myocardial Cx43 expression, and it is more advance in technique and more credibility in observed results than general dye of immunohistochemistry.