右心室肥大时心肌间质胶原改建及其前胶原基因的表达

　　【摘要】　目的　了解法乐四联症肥大右室心肌间质Ⅰ、Ⅲ型胶原的改建及与前胶原基因mRNA表达的关系，为防治心肌间质胶原改建提供新的依据和途径。方法　用生化方法定量分析了22例法乐四联症患者和8例非心血管及胶原系统疾病尸检者的右室心肌间质中的胶原含量和Ⅰ、Ⅲ型胶原比值，以及用斑点杂交法测定法乐四联症患者右室心肌间质Ⅰ、Ⅲ型前胶原基因mRNA的表达。结果　法乐四联症组心肌间质胶原含量为（14.85±2.48）μg/mg总蛋白，较对照组(7.55±1.89) μg/mg总蛋白明显增多（P＜0.05）；其Ⅰ/Ⅲ型胶原比值为5.10±1.84，较对照组2.27±0.58显著增高（P＜0.05）；法乐四联症组右室心肌间质胶原含量与Ⅰ、Ⅲ型前胶原基因表达强度的相关系数分别为0.80（P＜0.001）、-0.277（P＞0.10）。右室心肌间质胶原Ⅰ/Ⅲ型比值与Ⅰ/ Ⅲ型前胶原基因表达强度比值呈正相关，r=0.47（P＜0.05）。结论　提示法乐四联症肥大右室心肌间质存在以胶原含量增多和Ⅰ/Ⅲ型比值增高为特点的胶原改建，且主要与Ⅰ型前胶原基因mRNA转录水平上调有关。

Remodeling of myocardial interstitial collagen and procollagen gene expression

　　【Abstract】　Objective　To investigate the characteristics and procollagen gene expression of myocardial interstitial collagen of right ventricle in tetralogy of Fallot (TOF).Methods　Samples of the infundibular septum from 22 patients with TOF and 8 patients without cardiovascular disease and collagen system disease as control were studied. Collagen was determined by biochemical methods, Pro α(I) mRNA, Pro α(III) mRNA levels were determined by dot blot hybridization.Results　The hydroxyproline concentration and the ratio of type Ⅰ/Ⅲ collagen in the right ventricle with TOF were significantly higher than those in controls ［14.85±2.48 (±s) μg/mg total protein vs 7.55±1. 89 μg/mg total protein, respectively, P＜0.05; 5.10±1.84 vs 2.27±0.58, P＜0.05, respectively］. The correlation between the hydroxyproline concentration with the level of Pro α(Ⅰ)mRNA, Pro α(Ⅲ) mRNA were 0.80 (P＜0.001) and -0.277 (P＞0.10), respectively. The correlation between the ratio of type I/III collagen and the ratio of type Ⅰ/Ⅲ procollagen mRNA was positive (r=0.47, P＜0.05).Conclusion　Increased collagen and the ratio of type Ⅰ/Ⅲ collagen are the characteristics in collagen remodeling of the hypertrophic right ventricle in TOF. Enhanced type Ⅰ procollagen gene expression may be the cause of the increased collagen synthesis.

　　【Key words】　tetralogy of Fallot　　myocardium　　coll

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