發(fā)布時間：2018-09-02 09:45

【摘要】：目的研究脂肪因子在退行性主動脈瓣疾病(DAVD)患者血液和瓣膜標本中的表達特點。方法收集2012年9月至2015年9月在海南省人民醫(yī)院心外科因退行性主動脈瓣病變行手術(shù)切除的嚴重鈣化主動脈瓣標本和血液標本80例[男40例,女40例,年齡(61±6)歲],其中40例合并有代謝綜合征(MS);以及因夾層動脈瘤或心臟移植進行手術(shù)切除的正常主動脈瓣標本8例[男6例,女2例,年齡(48±7)歲];健康成人志愿者血液標本40例[男20例,女20例,年齡(60±8)歲]。ELISA法檢測chemerin、瘦素、脂聯(lián)素的血漿濃度,經(jīng)蘇木精-伊紅(HE)染色和免疫組織化學(xué)染色,觀察退行性主動脈瓣的組織學(xué)改變和脂肪因子chemerin、瘦素、脂聯(lián)素免疫組織化學(xué)染色的表達特點,RT-PCR檢測組織中chemerin、瘦素基因的表達。結(jié)果 chemerin、瘦素血漿濃度在DAVD患者較成人健康志愿者升高,DAVD合并MS較DAVD不合并MS患者升高;脂聯(lián)素血漿濃度在DAVD患者較成人健康志愿者降低,DAVD合并MS較DAVD不合并MS患者降低;與正常主動脈瓣比較,DAVD患者主動脈瓣增厚,結(jié)節(jié)性鈣化灶周圍存在脂肪樣組織,HE染色發(fā)現(xiàn)在鈣化灶周圍有巨噬細胞和其它的炎癥細胞、泡沫樣細胞、脂肪樣細胞、新生血管形成;免疫組織化學(xué)染色見正常主動脈瓣chemerin、瘦素、脂聯(lián)素陰性表達,DAVD患者主動脈瓣脂聯(lián)素陰性表達,然而可見chemerin和瘦素陽性表達,DAVD合并MS較DAVD不合并MS患者主動脈瓣中chemerin和瘦素表達增加;RT-PCR顯示DAVD合并MS較DAVD不合并MS患者主動脈瓣chemerin和瘦素mRNA表達增高。結(jié)論退行性主動脈瓣存在脂肪因子chemerin和瘦素表達,代謝綜合征影響退行性主動脈瓣脂肪因子chemerin和瘦素表達。
[Abstract]:Objective to study the expression of fat factor in blood and valve specimens of patients with degenerative aortic valve disease (DAVD). Methods from September 2012 to September 2015, 80 patients (40 males and 40 females) with severe calcified aortic valve and blood were collected from cardiac surgery department of Hainan Provincial people's Hospital. The age of the patients was (61 鹵6) years old, including 40 normal aortic valve specimens (male 6, female 2) complicated with metabolic syndrome (MS);) and surgical excision of dissecting aneurysm or heart transplantation. Blood samples were collected from 40 healthy adult volunteers [20 males and 20 females, aged (60 鹵8) years]. The plasma concentrations of chemerin, leptin and adiponectin were detected by Elisa, and were stained by hematoxylin-eosin (HE) staining and immunohistochemical staining. The histological changes of degenerative aortic valve and the expression characteristics of adiponectin chemerin, leptin and adiponectin immunohistochemical staining were observed. RT-PCR was used to detect the expression of chemerin, leptin gene. Results the plasma concentration of chemerin, leptin in DAVD patients was higher than that in adult healthy volunteers. The plasma concentration of adiponectin in DAVD patients was lower than that in adult healthy volunteers, and the plasma concentration of adiponectin in DAVD patients was lower than that in DAVD patients without MS. Compared with the normal aortic valve, the aortic valve thickened in the patients with DAVD, and the fatty tissue around the nodular calcification foci was found to have macrophages and other inflammatory cells, foam like cells, aliphatic cells, and fat like cells around the calcification foci. The expression of adiponectin and adiponectin in aortic valve were negative in normal aortic valve and adiponectin negative expression in aortic valve, and the expression of adiponectin in aortic valve was negative. However, the expression of chemerin and leptin in aortic valve of patients with chemerin and leptin + MS was higher than that of patients without DAVD and MS. RT-PCR showed that the expression of chemerin and leptin mRNA in aortic valve of DAVD with MS was higher than that with DAVD without MS. Conclusion the expression of fat factor chemerin and leptin exists in degenerative aortic valve. Metabolic syndrome affects the expression of chemerin and leptin in degenerative aortic valve.
【作者單位】： 海南省人民醫(yī)院心臟外科;華中科技大學(xué)同濟醫(yī)學(xué)院附屬協(xié)和醫(yī)院普外科;華中科技大學(xué)同濟醫(yī)學(xué)院附屬協(xié)和醫(yī)院心血管外科;
【基金】：國家自然科學(xué)基金資助項目(No.81270265) 海南省自然科學(xué)基金資助項目(No.814306) 海南省衛(wèi)生廳資助項目(No.瓊衛(wèi)2012-07)
【分類號】：R589

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