摘要
目的探讨心室辅助前、后心肌胶原含量改变与预后的关系。方法依据心室辅助后病人是否心脏移植分为移植组和撤离组，取左心室心肌行心肌胶原（Sircol法及羟脯氨酸定量）和蛋白测定，比较心室辅助前、后胶原及蛋白含量的差异与不同预后病人的关系。结果心室辅助前，除总羟脯氨酸外，两种预后病人的胶原和蛋白质含量的差别均有统计学意义（P〈0．05），撤离组明显高于移植组；撤离组蛋白质含量甚至高于移植组的辅助后测定值（P〈0．05）。移植组心室辅助后盐溶胶原及蛋白质和总羟脯氨酸含量较辅助前增加（P〈0．05）。结论扩张性心肌病病人心肌间质重塑的含义不同，部分胶原及蛋白质含量增加可能与良好预后有关；心室辅助改善心功能的机制可能与间质胶原改变有关。
Objective To investigate the relation between the changes of myocardial collagen content before and after ventricular assist device （LVAD） application and the prognosis in dilated cardiomyopathy. Methods Patients was divided to two groups according to the prognosis （weaning or transplantation） after LVAD application. Left ventricular samples were collected from the patients （weaning group n= 10, transplanted group n=8） at the time the LVADs were implanted, and again during cardiac transplantation （n=8）. The content of neutral salt soluble collagen （NSC） and acid soluble collagen （ASC） were measured by Sircol collagen assay and total collagen and insoluble collagen （ISC） by quantification of hydroxyproline. Moreover, protein quantification of each collagen fraction was performed simultaneously. Results Before LVAD implantation all collagen fraction and their protein contents were higher in the weaning group than that in the transplanted group （ P 〈 0.05）, but the difference in the collagen fraction disappeared after LVAD support. Comparison of the pre- and post-LVAD subgroups of the transplanted group showed an increase of NSC and its protein content and total hydruxyproline after LVAD support （ P 〈 0.05）. Conclusion The significances of myocardial interstitial remodeling in DCM are not identical. Some myocardial collagen and protein content increases may be related to good prognosis. The mechanism of LVAD improving cardiac function may be related to the changes of myocardial interstitial collagen.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
2008年第4期252-254,共3页
Chinese Journal of Thoracic and Cardiovascular Surgery
基金
本课题受广东省社会发展计划基金项目资助（2006B35801008）
志谢：衷心感谢柏林德国心脏中心Muller J和Hetzer R先生及柏林MDC分子医学中心Wallukat G先生对本研究的多方支持
关键词
心脏辅助装置
辅助循环
心肌病
扩张型
预后
Heart assist device Assisted circulation Cardiomyopathy, dilated Prognosis
