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目的:探讨心源性猝死者心肌细胞中连接蛋白(connexin CX)CX43和原癌基因蛋白(C-JUN)的表达及意义。方法:从2008-2011年青岛市市立医院病理科现有的蜡块中选取心性猝死者40例。其中冠心病22例,肺动脉栓塞10例,病毒性心肌炎5例,扩张性心肌病3例,选取因交通事故、外伤等死亡的病例10例作为对照组。应用免疫组织化学的方法分别检测各组病例中心室肌细胞中C-JUN和CX43蛋白的表达。结果:心源性猝死(SCD)组中心肌细胞中C-JUN的表达明显高于对照组(P<0.01)。而心性猝死组中CX43的表达却低于对照组。SCD组中心肌细胞中C-JUN与CX43的表达正相关(r=0.315,P=0.022)。结论:SCD患者心肌细胞中CX43表达和分布异常,结构的重塑导致了致死性心律失常的反生,SCD患者心肌中C-JUN高表达,且与CX43蛋白的表达呈正相关,提示二者可能共同参与了SCD的发生发展,不仅可以用于临床相应药物的研发,还可能称为法医学上对SCD的鉴别提供辅助指标。
Objective: To investigate the expression and significance of connexin CX CX43 and oncogene protein (C-JUN) in cardiomyocytes in sudden cardiac death. Methods: 40 cases of sudden cardiac death were selected from the existing wax blocks in the pathology department of Qingdao Municipal Hospital from 2008 to 2011. Among them, there were 22 cases of coronary heart disease, 10 cases of pulmonary embolism, 5 cases of viral myocarditis and 3 cases of dilated cardiomyopathy. Ten cases of death due to traffic accident and trauma were selected as the control group. Immunohistochemistry was used to detect the expression of C-JUN and CX43 in ventricular myocytes of all groups. Results: The expression of C-JUN in cardiomyocytes in sudden cardiac death (SCD) group was significantly higher than that in control group (P <0.01). However, the expression of CX43 in sudden cardiac death group was lower than that in control group. C-JUN was positively correlated with CX43 expression in cardiomyocytes of SCD group (r = 0.315, P = 0.022). CONCLUSIONS: The expression and distribution of CX43 in cardiomyocytes of SCD patients are abnormal. The remodeling of the structure leads to the reverse generation of lethal arrhythmia. The expression of C-JUN in myocardium of SCD patients is highly correlated with the expression of CX43 protein, suggesting that both may Participate in the occurrence and development of SCD, not only can be used for clinical development of corresponding drugs, may also be referred to forensic identification of SCD to provide additional indicators.