医学论文-房颤病人心房肌浆网 RyR2 受体 mRNA 表达变化的研究.docVIP

医学论文-房颤病人心房肌浆网 RyR2 受体 mRNA 表达变化的研究 ????????????????????????????????? 作者：周炯峰 夏小杰 陈怡粤? 【摘要】? 目的：研究心房颤动（房颤）患者肌浆网钙释放通道 ryanodine 受体（ryanodine receptor type2, RyR2）mRNA表达的改变，探讨房颤电重构与结构重构的发生机制。方法：38 例风心病二尖瓣狭窄接受外科手术者，手术时取右心房及右心耳各约 100 mg，通过逆转录 - 聚合酶链反应技术，以 GAPDH 为内参照，测量肌浆网 RyR2 受体的 mRNA 的变化。结果：房颤者肌浆网 RyR2 受体 mRNA 较窦性心律者上调，心房不同部位无差别。结论：房颤患者 RyR2 受体mRNA 上调，说明肌浆网 Ca2+ 超负荷与肌浆网钙库的释放增加有关。 【关键词】? 心房颤动；钙调蛋白；肌浆网 ??? 〔Abstract〕??? Objective???? To? investigate? the? change? of? RyR2? receptor? mRNA? expression? in? sarcoplamicreticular? and? to? explore? the? reasons? for? calcium? overloading? in? initiating? and? maintaining? atrial? fibrillation? (AF).Methods???? 38? patients? with? mitral? stenosis? undergoing? open? heart? surgery? were? studied.? 100? mg? tissuewas? obtained? from? the? right? appendage? and? the? right? atrium? respectively.? The? messenger? ribonucleic? acid(mRNA)? amount? of? intracellular? stored? calcium? releasing? genes? of? sarcoplamic? reticular? was? measured? byreverse? transcription-polymerase? chain? reaction? (RT-PCR)? and? normalized? to? the? mRNA? levels? of? glyceraldehydes? 3-phosphate? dehydrogenase? (GAPDH).??? Results???? Up-regulation? of? RyR2? mRNA? was? found? in? human? AF? compared? with? healthy? control.? There? was? no? difference? in? its? expression? between? the? right? atriums? and? the? right? appendages.??? Conclusion???? The? holmium? laser? with? percutaneous? nephrolithotripsy? is? a? saft? and? effectivetechnique? for? superior? segment? ureter? calculi,? which? can? decrease? extraordinarily? the? residual? rate? of? stone. ??? 〔Key? Words〕??? Atrial? fibrillation;? Calmodulin;? Sarcoplasmic? reticulum ??? 心房颤动（房颤）是临床上最常见的心律失常，房颤的发病机制十分复杂，目前大多数学者认为与电重构有关，电重构机制还不太清楚。最近研究认为与细胞内钙离子的超负荷有关[1]，本研究观察房颤患者心房肌浆网 ryanodine 受体（RyR2）mRNA 表达的改变，探讨房颤引起心房电重构的机制。 ??? 1??? 材料与方法 ??? 1.1??? 一般资料??? 1999 年 9 月 - 2000 年 6 月住院并接受开胸换瓣手术患者的风心病二尖瓣狭窄 38 例（其中 33 例来源于南京医科大学第一附属医院胸外科），男 16 例，女 22 例，年龄 27~70（48.605±11.732）岁。A 组：窦性心律 13 例；B 组：阵发性房