补阳还五汤对猪冠状动脉支架植入术后支架早期内皮化及内皮祖细胞的影响  

Effect of Buyang Huanwu Decoction on early stent endothelialization and endothelial progenitor cells after coronary artery stent implantation in pigs

作　　者：陈弢[1] 刘宗军[2] 郜俊清[2] 于宏梅[1] 赵德强[1] 汪蔚青[1] CHEN Tao;LIU Zongjun;GAO Junqing;YU Hongmei;ZHAO Deqiang;WANG Weiqing(Department of Cadre Ward,Putuo Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200062,China;Department of Cardiology,Putuo Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200062,China)

机构地区：[1]上海中医药大学附属普陀医院干部科,上海200062 [2]上海中医药大学附属普陀医院心内科,上海200062

出　　处：《上海中医药杂志》2022年第5期74-80,共7页Shanghai Journal of Traditional Chinese Medicine

基　　金：上海市医学重点专科项目(ZK2019A11);上海市普陀区卫生健康系统临床优势学科项目(2019ysxk01);中华中医药学会青年人才托举工程项目(QNRC2-B03);上海中医药大学预算内项目(2019LK035)

摘　　要：目的研究补阳还五汤对猪冠状动脉支架植入术后(简称“猪冠脉支架后”)支架早期内皮化的作用以及对内皮祖细胞(EPCs)功能调节的机制。方法雄性小香猪12只,每只猪均植入1枚3.0 mm×18.0 mm的火鹰支架,制作猪冠状动脉球囊损伤支架植入模型,分为治疗组(补阳还五汤+常规西药治疗)和对照组(常规西药治疗)2组。每组6只猪,共干预30 d。通过对该模型的实验研究,观察补阳还五汤对猪冠脉支架后内皮化的影响。采用光学相干断层扫描检测(OCT)评估支架内皮化的情况,流式细胞技术研究补阳还五汤对外周循环EPCs数量的影响,并以体外培养的方法,研究补阳还五汤对EPCs的血管内皮生长因子(VEGF)和碱性成纤维细胞生长因子(bFGF)表达的影响。结果(1)动物实验结果显示,与对照组比较,治疗组能够促进支架内皮化,支架表面内皮覆盖率更高;术后第3天、第5天、第7天外周循环EPCs的数量显著增多,差异有统计学意义(P<0.001)。(2)体外EPCs培养结果显示,与对照组比较,治疗组术后第7天VEGF和bFGF的表达升高(P<0.05)。结论补阳还五汤可增加猪冠脉支架后模型外周循环EPCs的数量,并可上调其VEGF、bFGF的表达,有望对促进支架内皮化起到关键性作用。Objective To study the effect of Buyang Huanwu Decoction on the endothelialization of coronary stents and the mechanism of regulating the function of endothelial progenitor cells(EPCs).Methods Twelve male minipigs were divided into two groups:the treatment group(Buyang Huanwu Decoction+routine Western medicine treatment)and the control group(routine Western medicine treatment).Each minipig was implanted with a firehawk stent of 3.0 mm×18.0 mm to establish the stent implantation model of porcine coronary artery balloon injury.Six minipigs in each group were intervened for 30 days.Through the experimental study on the stent implantation model of porcine coronary artery balloon injury,the effect of Buyang Huanwu Decoction on the endothelialization of porcine coronary stent was observed.Optical coherence tomography(OCT)was used to evaluate the endothelialization of stents.Flow cytometry was used to study the effect of Buyang Huanwu Decoction on the number of EPCs in peripheral circulation,and the effect of Buyang Huanwu Decoction on the expression of vascular endothelial growth factor(VEGF)and basic fibroblast growth factor(bFGF)in EPCs was studied.Results①The results of animal experiment showed that compared with the control group,the treatment group could promote the endothelialization of the stent,the endothelial coverage rate of the stent surface was higher,and the number of peripheral circulating EPCs increased significantly on the 3rd,5th and 7th day after operation,and the difference was statistically significant(P<0.001).②The results of EPCs culture in vitro showed that the expressions of VEGF and bFGF in the treatment group were higher than those in the control group on the 7th day after operation(P<0.05).Conclusion Buyang Huanwu Decoction can increase the number of EPCs in peripheral circulation and up-regulate the expression of VEGF and bFGF in porcine coronary artery balloon injury model,which is expected to play a key role in promoting stent endothelialization.

关 键 词：补阳还五汤 冠心病 小香猪 内皮祖细胞 支架内皮化 中药研究 

分 类 号：R541.4[医药卫生—心血管疾病]