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目的:观察心力衰竭(HF)患者心肌组织中钠氢交换体1(natrium-hydrogen exchanger 1,NHE1)的表达及其与血浆内皮素-1(ET-1)及心肌胶原的相关性,探讨NHE1、ET-1在HF、心肌纤维化发生发展中的作用。方法:采用实时荧光定量PCR(FQ-PCR)检测35例HF患者心肌组织中NHE1 mRNA的表达水平。采用放射免疫分析法分别测定受试者血浆ET-1及Ⅰ型前胶原羧基端肽Ⅰ(PⅠCP)和Ⅲ型前胶原氨基端肽(PⅢNP)的含量。同时用心脏多普勒超声检查心脏左房内径、左室射血分数(LVEF%)。结果:FQ-PCR检测心功能Ⅰ、Ⅱ、Ⅲ级组HF患者心肌组织中NHE1 mRNA的△C t值,分别为6.29±0.66、5.01±0.60和4.40±0.74。心功能Ⅱ级、Ⅲ级组患者心肌组织中NHE1 mRNA的表达明显高于心功能Ⅰ级组(P<0.01),心功能Ⅲ级组患者心肌组织中NHE1 mRNA的表达明显高于心功能Ⅱ级组(P<0.05)。HF组ET-1及PⅠCP、PⅢNP的含量较对照组明显升高(P<0.01),并随着HF程度的加重而增加,心功能Ⅱ级和Ⅲ级组显著高于心功能Ⅰ级组(P<0.05,P<0.01),心功能Ⅲ级组显著高于心功能Ⅱ级组(P<0.05);且ET-1及PⅠCP、PⅢNP的含量与NHE1 mRNA的△C t值(r=-0.587,P<0.01)呈显著的负相关。ET-1与PⅠCP、PⅢNP含量(r=-0.418,P<0.05)呈显著的正相关。结论:HF患者NHE1 mRNA的表达与ET-1及PⅠCP、PⅢNP的含量均密切相关。NHE1在HF、心肌纤维化的发生和发展过程中可能起着重要作用。
Objective: To observe the expression of NHE1 and its relationship with plasma endothelin-1 (ET-1) and myocardial collagen in patients with heart failure (HF) and to investigate the relationship between NHE1 , ET-1 in the occurrence and development of HF and myocardial fibrosis. Methods: The expression of NHE1 mRNA in myocardium of 35 HF patients was detected by real-time fluorescence quantitative PCR (FQ-PCR). Radioimmunoassay was used to determine the content of plasma endothelin-1 and type Ⅰ procollagen carboxy-terminal peptide Ⅰ (PⅠCP) and type Ⅲ procollagen aminoterminal peptide (PⅢNP) in subjects. At the same time, heart Doppler ultrasound examination of the left atrium diameter, left ventricular ejection fraction (LVEF%). Results: The △ C t values of NHE1 mRNA in myocardium of patients with heart function Ⅰ, Ⅱ and Ⅲ levels of FQ-PCR were 6.29 ± 0.66, 5.01 ± 0.60 and 4.40 ± 0.74, respectively. The expression of NHE1 mRNA in myocardium of grade Ⅱ and Ⅲ group was significantly higher than that of level Ⅰ (P <0.01). The expression of NHE1 mRNA in myocardial tissue of grade Ⅲ group was significantly higher than that of grade Ⅱ Group (P <0.05). The levels of ET-1, PⅠCP and PⅢNP in HF group were significantly higher than those in control group (P <0.01), and increased with the increase of HF level. The levels of ET-1, PⅠCP and PⅢNP in HF group were significantly higher than those in I / R group (P <0.05, P <0.01). The level of ET-1, PⅠCP and PⅢNP and the value of △ C t of NHE1 mRNA in heart function Ⅲ group were significantly higher than those in cardiac function Ⅱ group (r = 0.587, P <0.01) showed a significant negative correlation. ET-1 and PⅠCP, PⅢNP content (r = -0.418, P <0.05) showed a significant positive correlation. Conclusion: The expression of NHE1 mRNA in HF patients is closely related to the contents of ET-1, PⅠCP and PⅢNP. NHE1 may play an important role in the occurrence and development of HF and myocardial fibrosis.