β-原肌球蛋白在不同心肌病患者心肌组织中的表达及临床价值研究

doi:10.12114/j.issn.1007-9572.2025.0182

中国全科医学 ›› 2026, Vol. 29 ›› Issue (03): 311-315.DOI: 10.12114/j.issn.1007-9572.2025.0182

• 论著 • 上一篇

β-原肌球蛋白在不同心肌病患者心肌组织中的表达及临床价值研究

王学胜¹, 张羽松¹, 龚福汉¹, 蒋丁胜²^,^*()

1．554309　贵州省铜仁市人民医院心血管内科
2．430030　湖北省武汉市，华中科技大学同济医学院附属同济医院心脏大血管外科

收稿日期:2025-06-03 修回日期:2025-08-10 出版日期:2026-01-20 发布日期:2025-12-11
通讯作者: 蒋丁胜
作者贡献：
王学胜负责课题思路和文章撰写；张羽松负责数据分析和图表制作；龚福汉提供经费支持；蒋丁胜负责课题思路、标本收集和实验。
基金资助:
贵州省科技厅面上项目(黔科合基础MS〔2025〕034); 贵州省卫生健康委科学技术基金项目(gzwkj2023-311); 贵州省高层次创新型人才培养千层次创新型人才(2024-〔2023〕-063)

Expression and Clinical Implications of β-tropomyosin in Myocardial Tissues Across Cardiomyopathies

WANG Xuesheng¹, ZHANG Yusong¹, GONG Fuhan¹, JIANG Dingsheng²^,^*()

1. Department of Cardiology, Tongren People's Hospital, Tongren 554309, China
2. Division of Cardiovascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China

Received:2025-06-03 Revised:2025-08-10 Published:2026-01-20 Online:2025-12-11
Contact: JIANG Dingsheng

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摘要/Abstract

摘要： 背景 β-原肌球蛋白（TPM2）是调控肌肉收缩的关键结构蛋白，其表达异常与多种疾病的发生密切相关。然而，TPM2在不同类型心肌病中的表达特征尚不明确。目的探讨TPM2在肥厚型心肌病（HCM）、扩张型心肌病（DCM）及冠心病（CAD）患者心肌组织中的表达特征及其临床意义。方法选取2016年1月—2021年6月于华中科技大学同济医学院附属同济医院接受心脏移植或室间隔部分切除术的HCM（室间隔组织，n=13）、DCM（左心室组织，n=48）、CAD（左心室梗死周边区及非梗死区组织，n=8）患者，并选取8例供体心脏（左心室8例、室间隔6例）作为对照。构建包含77例样本的组织芯片，采用免疫组化法检测TPM2蛋白表达水平，结合临床资料进行相关性分析。结果与供体相比，HCM室间隔组织TPM2表达降低（P<0.05）。HCM室间隔组织TPM2表达水平与左心室舒张末期容积（r=0.478，P=0.018）及左心室侧壁厚度（r=0.475，P=0.040）呈正相关。与供体相比，DCM左心室组织TPM2表达降低（P<0.05）。CAD梗死周边区和非梗死区TPM2表达水平分别与供体比较，差异无统计学意义（P>0.05）。结论 TPM2在不同心肌病中的表达呈现异质性，其中HCM患者室间隔组织TPM2表达下调与心室重构显著相关，提示其在HCM病理进程中可能发挥重要作用，或为潜在治疗靶点。

关键词: 扩张型心肌病, 肥厚型心肌病, 冠心病, β-原肌球蛋白

Abstract:

Background

β-tropomyosin (TPM2) is a key structural protein that regulates muscle contraction, and its abnormal expression is closely associated with the development of various diseases. However, the expression patterns of TPM2 in different types of cardiomyopathies remain unclear.

Objective

To investigate the expression patterns and clinical relevance of TPM2 in myocardial tissues from patients with hypertrophic cardiomyopathy (HCM), dilated cardiomyopathy (DCM), and coronary artery disease (CAD).

Methods

Myocardial tissue samples were collected from patients who underwent heart transplantation or septal myectomy at Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology between January 2016 and June 2021, including HCM (septal tissues, n=13), DCM (left ventricular tissues, n=48), and CAD (peri-infarct and non-infarct regions of the left ventricular, n=8). Eight donor hearts (left ventricular tissues, n=8, and septal tissues, n=6) were included as controls. A tissue microarray containing 77 samples was constructed. TPM2 protein expression was assessed by immunohistochemistry and its clinical relevance was analyzed.

Results

Compared to the donor group, TPM2 expression was significantly reduced in the septal tissue of HCM patients (P<0.05). In the HCM group, TPM2 expression in septal tissue was positively correlated with left ventricular end-diastolic volume (r=0.478, P=0.018) and left ventricular lateral wall thickness (r=0.475, P=0.040). TPM2 expression was also significantly reduced in the left ventricular tissue of DCM patients compared to the donor group (P<0.05). In the CAD group, TPM2 expression levels in both peri-infarct and non-infarct regions showed no significant difference compared to controls (P>0.05).

Conclusion

TPM2 exhibits heterogeneous expression patterns across different cardiomyopathies. In HCM patients, downregulation of TPM2 in septal tissue is significantly associated with ventricular remodeling, suggesting that TPM2 may play a critical role in the pathogenesis of HCM and may serve as a potential therapeutic target.

Key words: Dilated cardiomyopathy, Hypertrophic cardiomyopathy, Coronary artery disease, Tropomyosin 2

王学胜,张羽松,龚福汉,等. β-原肌球蛋白在不同心肌病患者心肌组织中的表达及临床价值研究[J]. 中国全科医学, 2026, 29(03): 311-315. DOI: 10.12114/j.issn.1007-9572.2025.0182.
WANG Xuesheng,ZHANG Yusong,GONG Fuhan, et al. Expression and Clinical Implications of β-tropomyosin in Myocardial Tissues Across Cardiomyopathies[J]. Chinese General Practice, 2026, 29(03): 311-315. DOI: 10.12114/j.issn.1007-9572.2025.0182.

图/表 3

表1 HCM、DCM和CAD患者临床基本资料比较

Table 1 Comparison of basic clinical data among patients with HCM, DCM and CAD

分类	例数	性别（男/女）	年龄（±s，岁）	BMI （±s，kg/m²）	高血压史[例（%）]	糖尿病史[例（%）]	LVEDV （±s，mL）	LVLWT （±s，mm）	EF （±s，%）
HCM患者	13	9/4	53.1±11.4	23.5±2.0	6（46.2）	2（15.4）	41.25±14.13	9.9±4.2	60.95±13.89
DCM患者	48	40/8	42.0±15.1	21.7±3.8	7（14.6）	7（14.6）	71.51±12.17		25.33±11.66
CAD患者	8	8/0	61.7±6.9	22.9±2.9	3（37.5）	3（37.5）	48.67±25.00		37.00±10.52
F（χ²）值		3.072^a	8.188	1.450	6.765^a	2.552^a	25.181		44.274
P值		0.215	<0.01	0.244	0.034	0.279	<0.01		<0.01

图1 TPM2在肥厚型心肌病患者心肌组织中表达情况注：A为TPM2特异性免疫组化染色；B为定量分析TPM2的相对表达量；C为TPM2相对表达量与HCM患者左心室舒张末期容积的相关性分析；D为TPM2相对表达量与HCM患者左心室侧壁厚度的相关性分析；TPM2=β-原肌球蛋白，HCM=肥厚型心肌病。

Figure 1 The expression of TPM2 in myocardial tissues of patients with hypertrophic cardiomyopathy

图2 TPM2在扩张型心肌病患者和冠心病患者心肌组织中表达检测注：A为TPM2特异性免疫组化染色，B为定量分析TPM2的相对表达量；CAD=冠心病，DCM=扩张型心肌病。

Figure 2 Detection of TPM2 expression in myocardial tissue of patients with dilated cardiomyopathy and coronary artery disease

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β-原肌球蛋白在不同心肌病患者心肌组织中的表达及临床价值研究

Expression and Clinical Implications of β-tropomyosin in Myocardial Tissues Across Cardiomyopathies

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