线粒体乙醛脱氢酶2突变型基因的心肌保护作用

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摘要目的：观察施行心脏手术的患者，携带线粒体乙醛脱氢酶2（ALDH2）突变型基因对心肌缺血再灌注损伤的保护作用。方法：将北京阜外医院小儿心脏外科71例施行法洛四联症根治术的患者根据ALDH2基因型检测结果分成2组：突变型组（携带ALDH2*2突变型基因）和野生型组（携带ALDH2*1野生型基因）。收集术中切除的右心室流出道心肌组织，采用分光光度计法检测ALDH2酶活性，丙二醛（MDA）和还原型谷胱甘肽（GSH）含量。体外循环升主动脉开放后20 h取血检测心肌肌钙蛋白值（cTnI）。结果：突变型组患者术中缺血心肌组织毒性醛类MDA含量更低（P=0.013），心肌保护物质GSH含量更高（P=0.011），并且突变型组患者术后有更低的cTnI值（P=0.015），更短的术后住院时间（P=0.017）。结论：携带ALDH2突变型基因可以明显降低术中缺血心肌组织毒性醛类物质的堆积，提高心肌组织GSH含量，并且具有更好的临床预后，对心肌缺血再灌注损伤具有保护作用。

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	张裕坚1
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关键词 ：线粒体乙醛脱氢酶2, 心脏手术, 缺血再灌注损伤, 心肌保护

Abstract：Objective: To investigate the protection of human mitochondrial aldehyde dehydrognase 2 gene mutations for patients undergone cardiopulmonary bypass (CPB). Methods: A prospective cohort of TOF patients (n=71) was recruited to investigate the influence of the ALDH2*2 allele on cardio-protection after surgical repair. The patients were divided into 2 groups: ALDH2*2 (n=45) and ALDH2*1 (n=26). The right atrial appendage was harvested. ALDH2 activity, MDA and GSH were analysed. The cTnI was tested 20 hours later after the surgery. The time in hospital were recorded. Results: ALDH2*2 carriers showed highter GSH. ALDH2*2 carriers showed lower MDA, cTnI, and shorter postoperative length of hospital stay. Conclusion: ALDH2*2 allele has a myocardial protection effect after ischemic reperfusion injury, it may associated with greater expression of GSH level.

Key words： human mitochondrial aldehyde dehydrogenase 2 cardiopulmonary bypass ischemic reperfusion injury myocardial protection

收稿日期: 2015-04-07

通讯作者: 徐旭仲，教授，主任医师，硕士生导师，Email：xuzhong@263.net。

作者简介: 张裕坚（1984-），男，福建古田人，住院医师，硕士。

链接本文:

https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2015/V45/I12/883

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