体外循环对机体铁稳态的影响及与心肌损伤的关系

发布时间：2018-03-23 12:07

本文选题：体外循环　切入点：心肌损伤　出处：《南京医科大学学报(自然科学版)》2017年06期

【摘要】：目的 :探讨体外循环(cardio pulmonary bypass,CPB)对机体铁稳态的影响及与心肌损伤的关系。方法 :选取6例因心脏手术进行CPB的患者,对其CPB前(T0)、CPB 30 min(T1)、CPB结束时(T2)和结束后1 h(T3)的红细胞数(red blood cell,RBC)、血红蛋白(hemoglobin,Hb)、铁蛋白(ferritin,Fer)等指标进行检测;构建大鼠心肌缺血再灌注模型,取假手术组以及缺血30 min分别再灌注2 h、3 h、4 h后各组大鼠的心肌组织,real-time PCR法检测心肌组织中铁稳态调节激素(Hepcidin)、膜铁转运蛋白1(ferroportin1,Fpn1)和转铁蛋白受体1(transferrin receptor 1,TfR1)的mRNA水平变化。Western blot方法检测上述3种基因的蛋白水平变化。HE染色方法检测心肌组织的炎症状态。结果:随着CPB进行,RBC、Hb逐渐下降,Fer逐步升高。在模拟体外循环过程的大鼠心肌缺血再灌注模型中,与假手术组相比,缺血30 min再灌注2 h、3 h、4 h组心肌中Hepcidin的mRNA和蛋白水平明显降低,但Fpn1和TfR1的mRNA和蛋白水平均有不同程度的增加。并且随着再灌注时间的推移,增加幅度逐渐减小。并且,与假手术组相比,缺血再灌注对大鼠的心肌组织造成了一定程度的炎症损伤。结论:心肌缺血再灌注通过影响心肌组织中铁代谢相关基因Hepcidin、Fpn1和TfR1的mRNA和蛋白表达水平从而影响血清铁状态,对心肌造成炎症损伤。
[Abstract]:Objective: to investigate the effect of cardiopulmonary bypass (CPB) on iron homeostasis and its relationship with myocardial injury. The red blood cell number, hemoglobulin Hb1, ferritin ferritin ferritin (CPB) were measured at the end of 30 min and 1 hour after the end of CPB, and the myocardial ischemia-reperfusion model was established in rats. The changes of mRNA levels in myocardial tissue of sham operation group and 30 min reperfusion group were detected by real-time PCR method after reperfusion for 2 h and 3 h and 4 h after ischemia, respectively. The levels of mRNA were detected by real-time PCR method. The levels of iron homeostasis regulatory hormone, membrane iron transporter 1 ferroportin 1 (Fpn1) and transferrin receptor 1(transferrin receptor 1 (TfR1) in myocardial tissue were detected by real-time PCR method. Western blot method was used to detect the protein level of the three genes. He staining method was used to detect the inflammatory state of myocardial tissue. Results: with the development of CPB, HB decreased gradually and Fer gradually increased. In the rat myocardium simulated by cardiopulmonary bypass (CPB), the level of Fer increased gradually. In the ischemia-reperfusion model, Compared with sham operation group, the levels of mRNA and protein of Hepcidin in myocardium of ischemia 30 min reperfusion 2 h and 3 h reperfusion 4 h group decreased significantly, but the mRNA and protein levels of Fpn1 and TfR1 increased in varying degrees. The increase is decreasing. And, compared with the sham-operated group, Conclusion: myocardial ischemia-reperfusion can affect the expression of mRNA and protein of iron metabolism-related genes (hepcidinine Fpn1 and TfR1) in myocardial tissue and thus affect serum iron status. Inflamed damage to the myocardium.
【作者单位】：苏州大学附属第二医院心胸外科;苏州大学附属第二医院风湿免疫科;南京医科大学第一附属医院心脏外科;
【基金】：苏州市科技局应用基础研究计划项目(SYS201341) 苏州大学青年教师自然科学基金项目(SDY2013A34) 苏大附二院青年职工预研基金项目(SDFEYQN1307)
【分类号】：R654.1

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