心肌缺血猝死心肌中高迁移率族蛋白B-1的表达研究

目的探讨高迁移率族蛋白B-1(High Mobility Group Box protein 1,HMGB1)在心肌缺血猝死后诊断中的法医学价值。方法收集不同案例心肌蜡块分为疑似早期心肌缺血猝死组(早期梗死组)20例、心肌梗死猝死组(心肌梗死组)15例、冠心病非心源性猝死组(对照组1)10例和正常心肌组(对照组2)10例,应用免疫组织化学二步法染色,观察心肌胞核和胞浆中HMGB1表达,用ImagePro Plus 6.0软件计算HMGB1表达的平均光密度,用SPSS 13.0对表达进行数据统计分析。结果 HMGB1在四组心肌细胞胞核中表达均呈阳性;早期梗死组和心肌梗死组胞浆均呈阳性表达,对照组1和对照组2胞浆呈阴性。各组平均光密度分别为0.3031±0.0557、0.3195±0.0523、0.0252±0.0030、0.0207±0.0029,早期梗死组和心肌梗死组的阳性反应与两个对照组相比存在显著差异(P﹤0.01)。结论 HMGB1可作为早期心肌缺血猝死的一个辅助诊断指标。

Study on the expression of High Mobility Group Box 1 in sudden death caused by acute myocardial ischemia

Objective To investigate applicability of High Mobility Group Box 1(HMGB1) in forensic medicine to the diagnosis in the cases of sudden death due to acute myocardial ischemia.Methods Myocardial paraffin blocks of 55 cases selected in our department were divided into 4 groups: early myocardial ischemia group with severe coronary heart disease(20 cases),myocardial infarction group(15 cases),control group 1,(coronary heart disease but not sudden cardiac death,10 cases) and control group 2,(without coronary hear disease died craniocerebral injury,10 cases).The positive expression of HMGB1 in the myocardial nucleus and endochylema were observed by immunohistochemical method.Average optical density of HMGB1 in the cases of both early myocardial ischemia group and myocardial infarction group,but not in the myocardial cytoplasm in the cases of 2 control groups.Average optical density of HMGB1 expression in each group is respectively 0.3031±0.0557,0.3195±0.0523,0.0252±0.0030,0.0207±0.0029.The positive expression of HMGB1 is of significant difference between the first two experimental groups and two control groups.Conclusion The positive expression of HMGB1 may be an important index for diagnosis of acute myocardial ischemia.