中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (37): 6979-6984.doi: 10.3969/j.issn.1673-8225.2010.37.033

• 组织构建基础实验 basic experiments in tissue construction • 上一篇    下一篇

低能量体外心脏震波对急性心肌梗死后心肌基质金属蛋白酶系统及缺血心肌毛细血管密度的影响

陶四明1，郭  涛2，王  钰2，蔡红雁2，羊  超2   

  1. 1云南省第二人民医院心脏内科，云南省昆明市650021；2昆明医学院第一附属医院心脏内科，云南省昆明市 650031　
  • 出版日期:2010-09-10 发布日期:2010-09-10
  • 通讯作者: 郭涛，教授，博士生导师，昆明医学院第一附属医院心脏内科，云南省昆明市 650031 guotao20@hotmail.com
  • 作者简介:陶四明☆，男，1977年生，汉族，云南省江川县人，主治医师，博士，2004年昆明医学院毕业，主要从事介入心脏病学及冠心病血管新生研究。 taosm6450@126.com
  • 基金资助:

    云南省社会攻关项目(2006SG10)；云南省社会发展计划项目(2008CD007)。

Effects of low-energy extracorporeal shock wave on myocardial matrix metalloproteinase system and ischemic myocardial capillary density after acute myocardial infarction

Tao Si-ming1, Guo Tao2, Wang Yu2, Cai Hong-yan2, Yang Chao2   

  1. 1 Department of Cardiology, the Second People’s Hospital of Yunnan Province, Kunming   650021, Yunnan Province, China;  2 Department of Cardiology, First Affiliated Hospital of Kunming Medical College, Kunming   650031, Yunnan Province, China　
  • Online:2010-09-10 Published:2010-09-10
  • Contact: Guo Tao, Professor, Doctoral supervisor, Department of Cardiology, First Affiliated Hospital of Kunming Medical College, Kunming 650031, Yunnan Province, China Guotao20@hotmail.com
  • About author:Tao Si-ming☆, Doctor, Attending physician, Department of Cardiology, the Second People’s Hospital of Yunnan Province, Kunming 650021, Yunnan Province, China taosm6450@126.com
  • Supported by:

    the Society Tackle Program of Yunnan Province, No. 2006SG10*; the Society Development Program of Yunnan Province, No. 2008CD007*　

PDF

362

被引次数

8

摘要：

背景：研究表明震波治疗能明显改善心肌梗死后心室重塑。低能量体外心脏震波治疗是近年来新兴的血管新生治疗方法。基质金属蛋白酶系统及其抑制因子是影响心室重构过程的重要调节因子。
目的：观察低能量体外心脏震波治疗对猪急性心肌梗死后的心肌基质金属蛋白酶系统影响。
方法：将滇南小耳猪随机分为心脏震波治疗组，对照组和假手术组。心脏震波治疗组和对照组均建立急性心肌梗死模型，建模成功后震波治疗组接受3次低能量体外震波治疗(0.09 mJ/mm2，每点治疗200 击，共9点)，1个月后通过左心室造影评价左心室重塑情况，对照组建模成功后给予相同操作，但不施以震波及能量。假手术组不建模，震波治疗方法同对照组。用RT-PCR法检测各组动物心肌组织梗死交界区血管内皮生长因子，基质金属蛋白酶1，2，基质金属蛋白酶组织抑制因子1 mRNA表达水平，用免疫组织化学法检测各组动物缺血心肌毛细血管密度。
结果与结论：与对照组相比，心脏震波治疗组梗死心肌局部血管内皮生长因子 mRNA表达水平上调(P < 0.05)，促进局部心肌组织新生毛细血管增生，基质金属蛋白酶1 mRNA表达水平下调(P < 0.05)，基质金属蛋白酶组织抑制因子1 mRNA水平升高(P < 0.05)，左心室造影评价显示心室重塑指标改善，心脏震波治疗组缺血心肌毛细血管密度增高(P < 0.05)。结果显示体外心脏震波通过有效诱导急性缺血区血管新生，上调促血管新生因子表达水平，并重建局部心肌微循环。

关键词: 急性心肌梗死, 血管新生, 冲击波治疗, 基质金属蛋白酶, 心室重塑, 组织构建

Abstract:

BACKGROUND: Studies have shown that extracorporeal shock wave therapy can significantly improve ventricular remodeling after acute myocardial infarction. Low-energy extracorporeal shock wave therapy is an emerging treatment for angiogenesis. Matrix metalloproteinase system and its inhibitors are important regulatory factors in the process of ventricular remodeling.
OBJECTIVE: To observe the effect of low-energy extracorporeal shock wave therapy on matrix metalloproteinase system after acute myocardial infarction in pigs.
METHODS: A total of 25 domestic pigs were used in this study. All pigs were randomly divided into 3 groups: cardiac shock wave therapy group, control group, and sham-operation group. Pig models of acute myocardial infarction were established in cardiac shock wave therapy and control groups. After the success of modeling, low-energy extracorporeal shock wave treatment
(0.09 mJ/mm2, each point of healing 200 hit, a total of 9 points) was performed three times in the shock wave therapy group. After one month, left ventricular angiography evaluation was done based on left ventricular remodeling situation. The control group was given the same operation without shock and energy after the success of modeling. Sham- operation group underwent the same shock wave therapy as the control group without modeling. Expressions of vascular endothelial growth factor, matrix metalloproteinase 1, matrix metalloproteinase 2, tissue inhibitor of matrix metalloproteinase 1mRNA in the border zone of myocardial infarction were detected by RT-PCR method, and ischemic myocardial capillary density was detected by immunohistochemical method.
RESULTS AND CONCLUSION: Compared with the control group, vascular endothelial growth factor mRNA expression in regional myocardial tissues increased in the cardiac shock wave therapy group (P < 0.05), which promoted the proliferation of new capillaries in regional myocardial tissues. Matrix metalloproteinase 1mRNA expression reduced (P < 0.05), and tissue inhibitor of matrix metalloproteinase 1mRNA expression increased (P < 0.05). The left ventricular angiography showed an improvement in ventricular remodeling index, and the ischemic myocardial capillary density in the cardiac shock wave therapy increased (P < 0.05). The results showed that extracorporeal cardiac shock wave therapy could effectively induce angiogenesis, up-regulate the expression of angiogenic factor, and reconstruct regional myocardial microcirculation.

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