2019 年第 10 期 第 14 卷

冠状动脉钙化与心肌钙质沉积相关性的实验研究

An experimental study on the relation between coronary artery calcification and calcium deposition in cardiomyocytes

作者：王悦周元石凤茹赵蕾闻松男乔岩吕强白融喻荣辉

英文作者：

单位：100029首都医科大学附属北京安贞医院心内科（王悦、闻松男、乔岩、吕强、白融、喻荣辉），心外科（周元），病理科（石凤茹），影像科（赵蕾）

英文单位：

关键词：冠状动脉钙化；心肌细胞；钙质沉积

英文关键词：

• 摘要：

• 【摘要】目的    探讨冠状动脉钙化与心肌钙质沉积的相关性。方法    入选2017年1—6月于首都医科大学附属北京安贞医院行心脏瓣膜置换手术+心房颤动外科消融术+左心耳切除术的8例患者，术前均行心脏双源CT扫描，计算冠状动脉钙化积分。术中切除患者左心耳，分别用von Kossa染色和茜素红染色检测心肌组织的钙化情况，应用试剂盒检测心肌组织中碱性磷酸酶活性和钙含量；应用蛋白质印迹法检测心肌组织中成骨相关蛋白核心蛋白结合因子（Runx2）、骨桥蛋白、β-连环蛋白的表达，逆转录-聚合酶链反应检测骨桥蛋白、内皮素和生长素的mRNA表达。采用单因素线性回归和Logistic单因素回归分析冠状动脉钙化积分与以上各指标的相关性。结果    8例患者冠状动脉钙化积分分别为0、0、0、6、31、50、112、417分。Logistic单因素回归分析结果显示，冠状动脉钙化积分与心肌组织是否钙化无相关性（von Kossa染色：比值比=0.984，P=0.479；茜素红染色：比值比=0.983，P=0.356）。单因素线性回归分析结果显示，冠状动脉钙化积分与心肌组织钙含量、碱性磷酸酶活性、骨桥蛋白和β-连环蛋白表达及骨桥蛋白、内皮素和生长素的mRNA表达均无相关性（标准化回归系数=-0.221、0.558、-0.523、-0.562、0.129、0.021、0.020，P=0.595、0.154、0.186、0.154、0.751、0.971、0.956）；与Runx2蛋白表达呈线性负相关（标准化回归系数=-0.752，P=0.032）。结论    冠状动脉钙化与心肌钙质沉积无相关性。

• 【Abstract】Objective    To investigate the relation between coronary artery calcification and calcium deposition in cardiomyocytes. Methods    From January to June 2017, 8 patients undergoing cardiac valve replacement+atrial fibrillation ablation+left atrial appendectomy in Beijing Anzhen Hospital, Capital Medical University were recruited. Dual-source cardiac CT scanning was performed to calculate coronary calcium score before surgery. Left atrial appendage was removed. Calcium deposition in cardiomyocytes was observed by von Kossa staining and alizarin red staining. Alkaline phosphatase(ALP) activity and calcium content in myocardial tissue were tested by the kits. Expressions of osteogenesis associated protein core binding factor（Runx2）, osteopontin and β-catenin were detected by western blotting. Osteopontin, endothelin and ghrelin mRNA expressions were detected by reverse transcription-polymerase chain reaction. Relations between coronary calcium score and above indicators were analyzed by single factor linear regression and logistic regression. Results    Coronary artery calcification scores of 8 patients were 0, 0, 0, 6, 31, 50, 112 and 417, respectively. Logistic regression analysis showed no correlation between coronary artery calcification score and myocardial calcification (von Kossa staining: odds ratio=0.984, P=0.479; alizarin red staining: odds ratio=0.983, P=0.356). Linear regression analysis showed no correlation of coronary artery calcification score with protein expressions of myocardial calcium content, ALP activity, osteopontin and β-catenin protein expression, mRNA expressions of osteopontin, endothelin and ghrelin (normalized regression coefficient=-0.221, 0.558, -0.523, -0.562, 0.129, 0.021, 0.020; P=0.595, 0.154, 0.186, 0.154, 0.751, 0.971, 0.956); there was a negative correlation between coronary artery calcification score and Runx2 protein expression(standardized regression coefficient=-0.752, P=0.032). Conclusions    There is no correlation between coronary artery calcification and calcium deposition in cardiomyocytes.