风湿性心脏病心房肌缝隙连接重构与心房颤动关系研究

目的：探讨心房肌缝隙连接之连接蛋白(Cx)含量和分布改变与心房颤动(AF)之间的关系。方法：收集62例患者右心耳心肌标本。40例分无房颤(NAF)、阵发性房颤(PAF)和持续房颤(SAI)、对照组。以Western印迹分析Cx43和Cx40含量。另22例分NAF和SAF两组进行免疫组化分析，在激光共聚焦扫描显微镜下获取Cx40和Cx43荧光图像，对Cx斑数，Cx斑面积，Cx斑强度，及Cx斑数纵切面与横切面之比(V/Cells)和斑面积比(L／T Area)进行比较。结果：Cx43在NAF组和SAF组间无差异。Cx4O在NAF组和SAF组间有明显的差异(P＜O．01)，在PAF组有升高趋势。免疫组化显示GJ中Cx4O斑较Cx43细小，荧光强度弱(P＜O．05)。Cx43斑数目、面积及荧光强度在NAF和SAF组间无差异。Cx40斑荧光强度有显著差别(P＜O．05)。Cx40斑L／T Cells，L／T Area在NAF和SAF组间有明显差异(分别为P＜O．05和P＜O．01)。结论：Cx43不参与AF重构，Cx40含量在房颤患者心肌中减低，房颤时Cx40斑向细胞连接的侧边分布增加。

Relation between gap junction remodeling and atrial fibrillation in atrial myocardium of rheumatic heart disease

Objective:To evaluate the relationsh ip between human atrial fibrillat ion (AF) and gap junction (GJ) remodeling in changes of connexins and intracellu lar GJ distribution pattern in rheumatic heart disease. M ethods: 62 pat ients were enrolled and tissue samples of right atrial appendage were removed in the surgery. 40 patients were divided into non-atrial fibrillation(NAF), paroxy smal atrial fibrillation(PAF),sustained atrial fibrillation(SAF) and contro l groups. Western blot analysis were carried out to detect the specific Cx43 and Cx40 protein. The other 22 patients were divided into NAF and SAF group s and all samples were carried out the immunohistochemistry and images were ob tained under the laser scanning confocal microscopy. Results: Western blot analysis showed no significant difference of Cx43 but a significant difference of Cx40 existed between NAF and SAF groups (P<0.01), and Cx 40 had a slight increase trend in PAF group. Immunohistochemical a nalysis showed that Cx40 spots were smaller and the intensity was weaker than t hose of Cx43 (P<0.05). No significant difference of cells,area and inten sity of Cx 43 spots existed between NAF and AF groups while Cx40 spot intensity was signifi cant (P<0.05). Both ratio of L/T Cells and L/T Area of Cx40 had significant differenc e between NAF and SAF group (P<0.05 and P<0.01, respectively). Conclusion: Cx43 do not participate remodeling in AF. The total amount of Cx40 was declined and the side-to-side distribution pattern was increased in AF.