病毒性心肌炎猝死心肌MMP-9和TGF-β1表达与心肌纤维化的关系

目的研究病毒性心肌炎心肌MMP-9、TGF-β1表达与心肌纤维化的关系,探讨其在病毒性心肌炎猝死鉴定中的作用。方法筛选30例病毒性心肌炎作为实验组（18例为明确性心肌炎组,12例为界限性心肌炎组）,另选10例非病毒性心肌炎作为对照组。Masson染色观察病毒性心肌炎心肌胶原增生的情况;免疫组化法检测MMP-9、TGF-β1的蛋白表达和组织定位,并用图像分析系统及统计学方法进行定量分析。结果病毒性心肌炎组心肌胶原纤维较对照组明显增多;MMP-9、TGF-β1的表达水平明显增高,MMP-9、TGF-β1的表达与心肌胶原纤维增生呈正相关。结论MMP-9、TGF-β1可能在病毒性心肌炎心肌纤维化过程中起重要作用,可以作为病毒性心肌炎猝死的辅助诊断的指标。

The expression of MMP-2, TGF-β1 in the cases of sudden death due to viral myocarditis and their relationship with myocardial fibrosis

Objective To research the role of matrix metalloproteinase-9(MMP-9), transforming growth factor β1(TGF-β1) in viral myocarditis(VM) and their relationships with myocardial fibrosis, and to explore the forensic significance on sudden death due to viral myocarditis. MethodsSelected 30 cases of VM as experimental group,there cases were divided into definite VM group(n=18) and borderline VM group (n=12);Non-VM(n=10) were selected as control group. Collagen hyperplasia was observed by Masson staining. The expression and localization of MMP-9 and TGF-β1 in viral myocarditis were quantified by immunohistochemical method. Image analysis systems and statistical methods were used for quantitative analysis. ResultsThe amount of collagen fibre in the viral myocarditis group was more than that in the control group. The expression of MMP-9 and TGF-β1 were increased obviously. MMP-9、TGF-β1 expression were positively correlated with the collagen hyperplasis. ConclusionsThe MMP-9 and TGF-β1 may contributes to myocardial fibrosis, and may act as the assistant diagnostic indexes of sudden death due to viral myocarditis.