p38丝裂素活化蛋白激酶对冠心病患者冬眠心肌细胞凋亡的影响

目的探讨冬眠心肌细胞内活化的p38丝裂素活化蛋白激酶对冬眠心肌细胞凋亡的影响。方法行冠状动脉搭桥术的冠心病患者10例,术前一周内用多巴酚丁胺超声负荷试验结合多普勒组织成像确定冬眠心肌及正常心肌的存在部位,冠状动脉搭桥术中根据检测结果进行取材(分别取正常心肌和冬眠心肌),并经电镜证实。取材心肌用Tunel法检测心肌细胞凋亡情况,免疫印迹法检测磷酸化p38的表达情况。分析冬眠心肌与正常心肌磷酸化p38及心肌细胞凋亡数是否存在差异;分析p38与心肌细胞凋亡之间的相关性。结果冬眠心肌细胞内磷酸化p38、心肌细胞凋亡数较正常心肌高;p38与心肌细胞凋亡数相关(r=0.816,P<0.05)。结论心肌慢性缺血缺氧时,心肌细胞内p38丝裂素活化蛋白激酶信号活化,活化的p38丝裂素活化蛋白激酶介导冬眠心肌细胞凋亡。

Influences of p38-Mitogen Activated Protein Kinase on Cardiomyocyte Apoptosis in Hibernating Myocardium of Patients with Coronary Artery Disease

Aim To observe the relationship of p38-mitogen activated protein kinase(p38MAPK) and cardiomyocyte apoptosis in hibernating myocardium(HM).Methods Ten coronary artery disease(CAD) patients scheduled for bypass surgery were underwent preoperative dobutamine stress echocardiography(DSE),doppler tissue image(DTI) to check the position of HM and intraoperative myocardial biopsies.The normal myocardium and the HM were obtained in operation.They were conformed by electron microscope.Cardiomyocyte apoptosis were detected by Tunel,phosphorylation of p38 was detected by Western blot.It was analyzed that phosphorylation of p38 and positive cardiomyocyte nuclei(PCN) of apoptosis of CHM were different or not in hibernating myocardium and normal myocardium.It was analyzed for the relationship of p38MAPK and PCN of apoptosis.Results Phosphorylation of p38 and PCN of apoptosis were significantly increased in CHM compared with normal myocardium.Phosphorylation of p38 and PCN of apoptosis were positive correlation in hibernating myocardium(r=0.816,P<0.05).Conclusion p38MAPK can be triggered by ischemia,and active p38MAPK intervene cardiomyocyte apoptosis.