M0LECULAR MECHANISIM AND BIOMARKER OF AORTIC DISSECTION

我们对42例B型急性主动脉夹层(AD)患者进行了评估，发现血清Tn-C在第7天显著升高，在第28天逐渐下降至正常范围。入院时第7天的血清TN-C水平与峰值C反应蛋白水平、FDP水平、D-二聚体水平和夹层水平的最大主动脉直径呈正相关。3例死亡患者入院时血清Tn-C水平明显高于存活患者。血清Tn-C水平在急性B型AD急性期显著升高，可能成为预测B型急性AD患者预后的新的生物标志物。在小鼠模型中，Tn-C在夹层的主动脉壁中层高度表达，并与α-SMA染色的血管平滑肌细胞面积一致。在用LacZ敲击TN-C报告基因的小鼠中，β-GAL染色显示夹层的主动脉壁中层，α-GAL阳性细胞也呈β-GAL阳性。我们发现在夹层的主动脉壁中产生TN-C的细胞是VSMCs。

We evaluated 42 patients with type B acute aortic dissection (AD), andserum TN-C levels significantly increased at 7 days and then gradually decreased to normal range at 28 days. Serum TN-C levels at 7 days correlated positively with peak C-reactive protein levels, FDP levels, D-dimer levels, and maximum aortic diameter at the dissection level on admission. Serum TN-C levels of 3 dead patients on admission were significantly higher than those of surviving patients. Serum TN-C levels were significantly elevated during acute stage and might be a novel biomarker to predict patient prognosis of type B acute AD.In mouse model, TN-C was highly expressed in the medial layer of the dissected aortic wall, andwas concordant with the area of the vascular smooth muscle cells (VSMCs) stained by α-SMA. In the TN-C reporter mouse knock-in with LacZ, the medial layer of the dissected aortic wall was stained by the β-gal, and furthermore αSMA-positive cells were also positive in β-gal. We found that the producing cells of TN-C were VSMCs in the dissected aortic wall.