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目的:探讨冠心病患者冬眠心肌细胞内活化的丝裂素活化蛋白激酶(p38MAPK)对心肌细胞凋亡的影响。方法:行冠状动脉搭桥术(CABG)的冠心病患者10例,术前1周内用多巴酚丁胺超声负荷试验结合多普勒组织成像确定冬眠心肌及正常心肌的存在部位,CABG术中根据检测结果进行取材(分别取正常心肌和冬眠心肌),并经电镜证实。取材心肌用Tunel法检测心肌细胞凋亡情况,免疫印迹法(Western-blot)检测磷酸化的p38的表达情况。结果:冬眠心肌细胞内磷酸化p38、心肌细胞凋亡数较正常心肌高;p38与心肌细胞凋亡数相关(P<0.05,r=0.816)。结论:心肌慢性缺血时,心肌细胞内p38MAPK信号活化,活化的p38MAPK介导冬眠心肌细胞凋亡。
Objective: To investigate the effect of mitogen - activated protein kinase (p38MAPK) activated in hibernating myocardium of patients with coronary heart disease on cardiomyocyte apoptosis. Methods: Ten patients with coronary artery disease underwent coronary artery bypass grafting (CABG) were enrolled. One week before operation, the sites of hibernating myocardium and normal myocardium were determined by dobutamine stress test combined with Doppler tissue imaging. According to the test results were taken (respectively normal and hibernating myocardium), and confirmed by electron microscopy. Cardiomyocytes were harvested for cardiomyocyte apoptosis assay by Tunel method. The expression of phosphorylated p38 was detected by Western-blot. Results: The phosphorylated phosphorylation of p38 in myocardium of hibernating myocardium was higher than that of normal myocardium; p38 was related to the apoptosis of cardiomyocytes (P <0.05, r = 0.816). CONCLUSION: In chronic myocardial ischemia, the p38 MAPK signal is activated in cardiomyocytes and the activated p38 MAPK mediates the apoptosis of hibernating myocardium.