Relationship of expression of p53 and Bcl2 with myocyte apoptosis in acute myocardial infarction with in-stantaneous death
- Author:
- No author available
- Journal Title:
- CHINESE CRITICAL CARE MEDICINE
- Issue:
- 11
- DOI:
- 10.3760/cma.j.issn.1008-6315.2000.11.067
- Key Word:
- 细胞凋亡,心肌;p53蛋白;Bcl2蛋白;心肌梗死,急性
Abstract： 目的:探讨p53和Bcl2蛋白在急性心肌梗死(AMI)猝死者心肌细胞凋亡中的作用.方法:用凋亡原位末端标记检测(TUNEL)法检测20例AMI猝死者和10例心脏正常车祸死亡者心肌细胞凋亡,用免疫组化法检测p53和Bcl2蛋白在心肌细胞中表达水平,并探讨其相互关系.结果:AMI猝死者梗死区心肌细胞凋亡数为(557.95±144.10)个/1 000个,明显高于正常对照组(34.30±20.68)个/1 000个(P<0.05);猝死者梗死区心肌细胞中p53蛋白表达阳性细胞数为(441.65±131.68)个/1 000个,明显高于正常对照组(20.20±26.27)个/1 000个(P<0.05),且与梗死区心肌细胞凋亡数成明显的正相关性(r＝0.655 3,P<0.002);Bcl2蛋白表达阳性细胞数为(36.25±43.17)个/1 000个,明显低于正常对照组(100.10±71.34 )个/1 000个(P<0.05),且与梗死区心肌细胞凋亡数成明显负相关性(r＝-0.8 10 3,P<0.001);梗死区心肌细胞内p53与Bcl2蛋白表达数之间呈明显的负相关性(r=-0.807 8,P<0.001).不同支数冠状动脉病变猝死者梗死区心肌细胞的凋亡数1支者(506.38±175.88)个/1 000个,2支者(554.38±92.1 5)个/1 000个,3支者(668.25±127.19)个/1 000个,均明显高于正常对照组(P 均<0.05);p53蛋白表达阳性细胞数:1支者(389.00±150.45)个/1 000个、2支者 (455.88±105.20)个/1 000个和3支者(518.50±123.95)个/1 000个均明显高于正常对照组(P均<0.05);Bcl2蛋白表达的阳性细胞数:2支者(25.25±1 4.10)个/1 000个明显低于正常对照组(P<0.05),而1支者(58.13±62.38 )个/1 000个和3支者(14.50±5.32)个/1 000个与正常对照组之间比较则无统计学上的差异(P均>0.05).有趋势表明,病变支数越多,梗死区心肌细胞内的凋亡越明显,p 53蛋白表达越高,而Bcl2蛋白表达越低;但1支、2支和3支病变者在心肌细胞凋亡数、p53和Bcl2蛋白表达量方面,相互之间比较无统计学上的差异,可能由于例数少所致.结论:AMI猝死者梗死区心肌细胞存在明显的凋亡现象,且受p53蛋白上调与Bcl2蛋白下调影响,p53蛋白与Bcl2蛋白共同调节心肌细胞凋亡.
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