目的 探讨扩张型心肌病与钙网蛋白(Calreticulin)、基质金属蛋白酶(MMPs)家族成员MMP-2和MMP-9之间的关系,为扩张型心肌病的预防和治疗提供理论论据.方法 试验分两组:扩张型心肌病组和对照组.分别收集14例扩张型心肌病患者及14例对照组全血及临床资料(年龄,性别,左房、右房、左室、右室舒张末期内径及左室射血分数等),提取血浆,通过蛋白免疫印迹法(western blotting)测定血浆钙网蛋白的表达水平,通过明胶酶谱法(Gelatin-PAGE)检测各标本血浆中MMP-2和MMP-9活性.结果 ①扩张型心肌病组与对照组比较,两组间左房、左室舒张末期内径、左室射血分数和MMP-9活性的差异有统计学意义.②在扩张型心肌病组中,MMP-9活性与左室射血分数呈负相关(r=-0.590,P<0.05),与左室舒张末径呈正相关(非正态分布等级相关:r=0.396,P<0.05),但与左房、右房、右室舒张末径和室间隔厚度均无相关关系.对照组中,MMP-9与左房、右房、左室、右室舒张末径和室间隔厚度均无相关关系.③两组比较,MMP-2活性差异无统计学意义,与左房、右房、左室、右室舒张末径,左室射血分数和室间隔厚度之间均无相关关系.④钙网蛋白在扩张型心肌病组的表达升高,但与对照组相比,两者间的表达水平差异无统计学意义(P>0.05).结论 ①MMP-9在扩张型心肌病患者左室重构中起重要作用,MMP-9的活性可作为评估心功能情况的参考指标之一.②钙网蛋白在扩张型心肌病病理过程中未直接参与其疾病发展,但未排除通过其他途径作用于该病理过程.
Objective To explore effects of calreticulin and matrix metalloproteinases in the pathogenesis of dilated cardiomyopathy. Methods The objects of study were divided into two groups: dilated eardiomyopathy group and control group. The persons without heart disease and pulmonary disease were selected in the control group. Both groups plasma and clinical information were collected. The expression of CRT in both groups were detected by the western blotting. The enzymatic activity of MMP-2 and MMP-9 in both groups were detected by the Gelatin-PAGE. Results (1)The enzymatic activity of MMP-9, left ventricular ejection fraction (LVEF) and the left ventricular end-diastolic diameter (LVDd) in DCM patients had significant difference compared to the control group (P〈0.05). (2)The activity of MMP-9 had relationship with the left ventricular end-diastolic diameter (LVDd) and left ventricular ejection fraction(LVEF) compared to the control group(r=0.396, P〈0.05 ). (3)On the contrary, there was no relationship between the activity of MMP-9 and the fight ventricnlar diameter (RV), left atrium (LA), right atrium (RA), intact ventricular septum (IVS). The activity of MMP-2 had no defference between two groups. MMP-2 also had no relationship with patients' LA, RA, RV, LVEF, LVDd and IVS. (4)There was no difference in the expression of CRT between two groups. Conclusion (1)The plasma MMP-9 had probably played important role in ECM degradation and ventricle remodeling in DCM patient. (2)Calreticulin was not directly involved in the pathogenesis development of DCM, but not exclusive role through other channels in the pathological process.