心肌病猝死者心肌连接蛋白43的免疫组化染色观察

目的探讨心肌病猝死者心肌连接蛋白43(Cx43)染色变化及其与猝死的关系。方法运用免疫组化和图像分析技术,分2组(A和B组)检测20例心肌病猝死者心室肌的Cx43染色情况;并与14例非心肌病猝死者(C组)的检测结果对照。结果扩张型心肌病(DCM)猝死组(A组,11例)心肌Cx43染色明显减弱,阳性着色斑点大小不等、深浅不一、分布不均,有的呈散在颗粒状;其它类型的心肌病猝死组(B组,9例)亦见类似变化;非心肌病猝死的对照组(C组,14例)未见明显变化。定量检测并经统计分析发现,Cx43蛋白染色阳性的面积,A组与B组和C组的差异有非常显著性意义(P<0.01),B组与C组的差异无显著性意义(P>0.05);而平均光密度各组之间的差异无显著性意义(P>0.05)。结论心肌病猝死者心肌Cx43免疫组化染色明显减弱,尤以扩张型心肌病明显;心肌病猝死者心肌Cx43变化可能与其猝死有一定关系。

Myocardial connexin43 expression in the cases of sudden death due to cardiomyopathy

Objective To explore the change of myocardial connexin43(Cx43) expression in the case of sudden death due to primary cardiomyopathy(PCM).Methods Immunohistochemiscal and image analytic techniques were used to investigate myocardial Cx43 expression in 20 cases of sudden death caused by PCM(group A and B) and 14 cases of control group who died of violent force and other diseases(group C),which were autopsied in our department from 1993 to 2003.Results Myocardial Cx43 expression decreased obviously in DCM group(group A,11 cases).Positive dying spots were different in size,distribution color and disparity,and some of them were distributed in the form of particle.There were similar changes in the cases of other PCM(group B,9 cases).Obvious change had not been observed in the control group(group C,14 cases).Quantitative data: there was remarkable difference about expression area(S value) between group A and B(p=0.0039) and between group A and C(p=0.0075),and there was not difference between group B and C(p=0.5558).And there was not difference among the 3 groups about average optical density(OD value) of Cx43 expression.Conclusion Myocardial Cx43 expression decreased obviously in the case of sudden death caused by PCM,especially in DCM.These alterations of quantity and distribution of myocardial Cx43 expression have probably relation to the sudden death of patients with PCM.