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目的研究病毒性心肌炎心肌MMP-9、TGF-β1表达与心肌纤维化的关系,探讨其在病毒性心肌炎猝死鉴定中的作用。方法筛选30例病毒性心肌炎作为实验组(18例为明确性心肌炎组,12例为界限性心肌炎组),另选10例非病毒性心肌炎作为对照组。Masson染色观察病毒性心肌炎心肌胶原增生的情况;免疫组化法检测MMP-9、TGF-β1的蛋白表达和组织定位,并用图像分析系统及统计学方法进行定量分析。结果病毒性心肌炎组心肌胶原纤维较对照组明显增多;MMP-9、TGF-β1的表达水平明显增高,MMP-9、TGF-β1的表达与心肌胶原纤维增生呈正相关。结论MMP-9、TGF-β1可能在病毒性心肌炎心肌纤维化过程中起重要作用,可以作为病毒性心肌炎猝死的辅助诊断的指标。
Objective To study the relationship between myocardial MMP-9, TGF-β1 expression and myocardial fibrosis in viral myocarditis, and to explore its role in the identification of sudden death of viral myocarditis. Methods Thirty patients with viral myocarditis were selected as the experimental group (18 patients with definite myocarditis and 12 patients with borderline myocarditis) and 10 patients with non-viral myocarditis as control group. Masson staining was used to observe the proliferation of myocardial collagen in viral myocarditis. The protein expression and tissue localization of MMP-9 and TGF-β1 were detected by immunohistochemistry and quantified by image analysis system and statistical method. Results Myocardial collagen fibers in viral myocarditis group were significantly higher than those in control group. The expression of MMP-9 and TGF-β1 was significantly increased. The expressions of MMP-9 and TGF-β1 were positively correlated with myocardial collagen fibers. Conclusion MMP-9 and TGF-β1 may play an important role in the process of myocardial fibrosis in viral myocarditis and may be used as an auxiliary diagnostic indicator of sudden death of viral myocarditis.