發(fā)布時間：2018-05-11 09:38

  本文選題：法醫(yī)病理學 + 心臟��； 參考：《四川大學》2004年博士論文

【摘要】：急性心肌缺血(acute myocardial ischemia, AMI)是局部心肌供血不足導致心肌組織灌注不良引起的心肌缺血性改變。常見原因是冠狀動脈粥樣硬化。冠狀動脈炎、栓塞、先天性畸形或功能性痙攣等亦可引起心肌缺血。冠狀動脈粥樣硬化性心臟病(冠心病)的特征是心肌缺血、缺氧。心臟性猝死(sudden cardic death, SCH)病例中,冠心病約占50%。猝死是法醫(yī)學研究的重點,冠心病猝死,發(fā)病突然、死亡迅速,發(fā)病后15min內(nèi)死亡占40%,15min至2h死亡占30%。急性心肌缺血早期病理改變常規(guī)組織病理學檢查有時難以發(fā)現(xiàn)明顯的形態(tài)改變,因此,需尋找敏感的診斷指標。 心肌細胞縫隙連接(gap junction, GJ)是由相鄰心肌細胞膜連接蛋白(Cormexin, Cx)六聚體鉚接成的細胞間低電阻通道,是心肌細胞間電耦聯(lián)、營養(yǎng)物質(zhì)及化學信息交換的重要結構基礎。Cx家族-連接蛋白是一種六聚體空心蛋白圓柱體,中央有一直徑約2nm的親水性中央小管,每個連接小體鑲嵌在細胞膜內(nèi),與相鄰細胞膜中的連接小體頂端緊密結合,細胞間的中央小管相通。Cx43的正常表達與分布,是心肌間隙連接通道電耦聯(lián)正常功能和心臟正常電活動及協(xié)調(diào)舒縮的重要保證。GJ電耦聯(lián)紊亂引起折返性心律失常,發(fā)生心電傳導減慢和單向阻滯可致心臟性死亡。Cx43表達和分布的異常是多種室性心率失常的解剖學基礎。 Cx家族的研究主要在臨床心血管疾病方面,尤對Cx43研究最多。90年代,國外研究主要集中在心律失常,如Peters等對心肌缺血、心肌梗死、心律失常及折返性心律失常的研究:Severs與Jongasma等人對心血管疾病的研究;國內(nèi)伍偉峰等對心房纖顫者Cx40、Cx43基因轉(zhuǎn)錄表達的研究;張萍等對壓力超負荷時心肌閏盤改變的研究等。近幾年,對Cx家族的研究范圍擴展到心臟以外的其它器官,研究對象也從Cx43到Cx家族的其
[Abstract]:Acute myocardial ischemia (myocardial ischemia, AMI) is a myocardial ischemic change caused by myocardial insufficiency. The common cause is coronary atherosclerosis. Coronary artery disease, embolism, congenital malformation or functional spasm can also cause myocardial ischemia. Coronary atherosclerotic heart disease (CHD) is characterized by myocardial ischemia and hypoxia. Coronary heart disease accounted for about 50% of sudden cardiac death in patients with Sudden cardic death, SCH). Sudden death is the focus of forensic research. Sudden death of coronary heart disease, sudden onset, rapid death, 40 minutes to 2 hours of death within the 15min accounted for 30% of death. In the early stage of acute myocardial ischemia, it is difficult to find obvious morphological changes in routine histopathological examination, so it is necessary to search for sensitive diagnostic indexes. Gap junctions (GJs) are low resistance intercellular channels riveted by adjacent cardiac cell membrane connectors Cormexin (CX), which are electrocoupler of myocardial cells. An important structural basis for the exchange of nutrients and chemical information. The CX family is a hexagonal hollow protein cylinder with a hydrophilic central tubule about the diameter of 2nm, each of which is embedded in the cell membrane. Close binding to the tip of the connective body in the adjacent cell membrane, the normal expression and distribution of the central tubule. Cx43. It is an important guarantee of normal function of electrical coupling of cardiac gap junction channel and normal electrical activity of heart and coordination of contraction and contraction. GJ electrical coupling disorder causes reentrant arrhythmias. The abnormal expression and distribution of .Cx43 in cardiac death caused by slow conduction and one-way block are the anatomical basis of various ventricular arrhythmias. The studies of CX family mainly focus on clinical cardiovascular diseases, especially on Cx43 in the 1990s. Foreign studies mainly focus on arrhythmia, such as Peters on myocardial ischemia, myocardial infarction, etc. Studies on Cardiovascular Disease in patients with Arrhythmia and reentrant Arrhythmia; study on Cardiovascular Disease in patients with Atrial Fibrillation by Jongasma et al.; study on transcription and expression of Cx40 Cx43 Gene in Atrial Fibrillation patients; study on changes of intercalated Disc in Myocardium under pressure overload by Zhang Ping et al. In recent years, the study of CX family has been extended to other organs other than the heart. The subjects have also been studied from Cx43 to CX family.
【學位授予單位】：四川大學
【學位級別】：博士
【學位授予年份】：2004
【分類號】：D919

【參考文獻】

相關期刊論文 前3條

1 張萍,何國祥,王國超,遲路湘;壓力超負荷時心肌閏盤的改變[J];中華心血管病雜志;2000年05期

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3 ;Expression of gap junction genes connexin 32 and connexin 43 mRNAs and proteins,and their role in hepatocarcinogenesis[J];World Journal of Gastroenterology;2002年01期

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本文編號：1873416