心源性猝死者窦房结病理学观察和HCN4、CX45的表达及其意义

目的:研究心源性猝死者窦房结病理学改变和超级化激活环核苷酸门控阳离子通道基因4(HCN4)、缝隙连接蛋白45(Cx45)的表达.方法:实验组为21例心源性猝死者,对照组18例(交通事故损伤致死9例,心脏破裂4例,肝破裂3例,脾破裂2例).经HE染色观察窦房结的形态学变化;应用免疫组化检测HCN4和Cx45在窦房结的表达.结果:心源性猝死组HCN4的表达高于对照组(P＜0.05),心源性猝死者窦房结Cx45的表达明显低于对照组(P＜0.01).结论:窦房结病理改变是引起心源性猝死的重要原因之一,HCN4表达的增高和Cx45表达的减少与心源性猝死的发生有一定的相关性.

Expression of HCN4 and Cx45 in sinus nodes of patients with sudden cardiac death and their significances

Objective:To investigate the pathological changes of sinus nodes in patients with sudden cardiac death and the expression of hyperpolarization activated cyclic nucleotide gated cation channel 4(HCN4)and connexin45(Cx45).Methods:Twenty-one cases of sudden cardiac death were chosen as experimental group while eighteen cases of non sudden death were chosen as the control group.Among the control group,nine cases were caused by traffic accident,four cases were caused by heart rupture,three cases were caused by liver rupture and two cases were caused by spleen rupture.HE staining sections were used to observed the morphology of sinus nodes.Immunohistochemical staining was employed to examine HCN4 and Cx45 expression in sinus nodes.Results:Expression of HCN4 in sinus nodes of patients with sudden cardiac death was significantly higher than that of the control group (p＜0.05)and Cx45 in sinus nodes of patients with sudden cardiac death was significantly lower than that of the control group(p＜0.01).Conclusions:Morphologic change in sinus nodes is an important reason for sudden cardiac death.Increased expression of HCN4 and decreased expression of Cx45 are correlated with the incidence of sudden cardiac death to some extent.