不同程度冠状动脉粥样硬化病变下心肌组织中melusin的表达研究

目的:观察不同程度冠状动脉粥样硬化病变下心肌组织的病理改变,检测心肌组织内melusin蛋白的水平,探讨melusin在冠心病的发生发展过程中所发挥的作用。方法:筛选尸检取材的冠心病案例,分3组:动脉粥样硬化斑块稳定者(B组);粥样硬化斑块不稳定但无血栓形成、斑块破裂、斑块内出血等任一种继发病变者(C组);斑块不稳定且伴有上述任一种继发病变者(D组)。以无心脏疾病死亡者为对照组(A组)。分别收集冠状动脉和心肌组织,常规HE染色观察各组心肌的结构变化,免疫组织化学染色、Western blot及real-time PCR法检测心肌组织内melusin的表达分布,利用logistic回归分析melusin的表达改变与冠心病发生发展的关系。结果:(1)与A组比较,其余3组心肌呈现肥大、萎缩、坏死及脂肪浸润等病理改变;(2) B组心肌组织中的melusin表达较A组增高,C组和D组中melusin表达较A组显著降低(P<0.05);(3) melusin在心肌细胞中的表达与冠心病发生发展呈负相关(OR=0.3;95%CI:0.2~0.4;P<0.01)。结论:人心肌组织中melusin蛋白可能是冠心病发病过程中心脏的保护因素,它在冠心病的发生发展过程中发挥了重要的作用。

Expression of melusin in myocardial tissues with different degrees of coronary atherosclerosis

AIM: To observe the pathological changes of myocardial tissues with different degrees of coronary atherosclerotic lesions, and to detect the level of melusin in myocardial tissue for exploring the role of melusin in the deve-lopment of coronary heart disease. METHODS: The cases of coronary heart disease were confirmed by autopsy and histopathological examination, and were classified into 3 groups: coronary atherosclerotic stable plaques(B group);atherosclerotic unstable plaques without thrombosis, plaque rupture, plaque hemorrhage and other secondary changes(C group);atherosclerotic unstable plaques with any of the secondary changes mentioned above(D group). The control group(A group) had no lesion of coronary artery. The coronary and myocardial tissues were collected separately, and routine HE staining of paraffin sections was performed to observe the histological structure of myocardium. The expression of melusin was detected by immunohistochemical staining, Western blot and real-time PCR. Logistic regression analysis was used to analyze the relationship between melusin expression changes and the development of coronary heart disease. RESULTS: Compared with A group, human cardiac myocytes showed pathological changes such as hypertrophy, atrophy, necrosis and adipose tissue infiltration in the other 3 groups. The expression of melusin in C and D groups was significantly lower than that in control group, while the expression of melusin was increased in B group(P<0.05). The expression of melusin in myocardial tissues was negatively correlated with the development of coronary heart disease(OR=0.3;95% CI: 0.2~0.4;P<0.01). CONCLUSION: Melusin in human myocardial tissue may be a protective factor of heart in coronary heart disease. It plays an important role in the development of coronary heart disease.