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目的:探讨晚期扩张型心肌病(DCM)患者心肌连接蛋白43(Cx43)表达变化及其意义。方法:运用免疫组化和图像分析技术,对5例晚期DCM患者和4例因其他心脏疾病(A对照组)行心脏移植手术切除的心脏及4例机械性损伤死者(B对照组)的左心室心肌Cx43蛋白表达进行定位和定量研究。结果:DCM患者心肌Cx43蛋白表达较清晰,主要位于心肌闰盘处,呈条状、斑点或颗粒状散在分布,有的散在分布于心肌细胞侧边;A对照组表达清楚,位于心肌闰盘处,主要呈条状,少数呈斑点状散在分布,而心肌侧边分布很少;B对照组阳性着色较淡,在闰盘处呈条状分布,少有斑点状散在分布,心肌侧边几无表达。定量检测和统计分析发现,DCM组心肌Cx43蛋白表达的量低于A对照组但高于B对照组。心肌Cx43蛋白表达的平均光密度,DCM组与A对照组、B对照组相比,A对照组与B对照组相比,差异均有统计学意义(P<0.01);心肌Cx43蛋白表达的S值,DCM组、A对照组、B对照组间比较,差异均无统计学意义(P>0.05)。结论:晚期DCM患者心肌Cx43蛋白表达的数量和分布均发生改变,这种变化很可能是导致DCM患者发生心律失常和心功能衰竭的病理基础。
Objective: To investigate the changes of myocardial connexin 43 (Cx43) expression in patients with advanced dilated cardiomyopathy (DCM) and its significance. Methods: Immunohistochemistry and image analysis were used to analyze the left and right heart of 5 patients with advanced DCM and 4 patients who underwent cardiac transplantation due to other heart disease (A control group) and 4 patients with mechanical injury (B control group) Ventricular myocardium Cx43 protein expression localization and quantitative study. Results: The expression of Cx43 protein in DCM patients was clearer, mainly located in the intercalated disc, scattered in spots, spots or granules, and some scattered in the side of cardiomyocytes. The expression of C in control group was clear , The main strip, a small number of spotted scattered, but little lateral distribution of myocardium; B control positive staining lighter, in the intercalated disc was strip-like distribution, less speckled scatter, a few side of the myocardium expression. Quantitative detection and statistical analysis found that the amount of myocardial Cx43 protein expression in DCM group was lower than that of A control group but higher than that of B control group. Compared with A control group and B control group, the average optical density of myocardial Cx43 protein expression in DCM group was significantly higher than that in B control group (P <0.01); the expression of Cx43 protein in myocardium There was no significant difference between DCM group, A control group and B control group (P> 0.05). CONCLUSION: The quantity and distribution of myocardial Cx43 protein in patients with advanced DCM are both changed, which may be the pathological basis of arrhythmia and heart failure in patients with DCM.