心肌梗死后心肌细胞凋亡及左室重塑过程中肝细胞生长因子的作用  

Role of hepatocyte growth factor on cardiomyocyte apoptosis and left ventricular remodeling after acute myocardial infarction

作　　者：宋明宝[1] 黄岚[1] 李爱民[1] 蒋世忠[1] 张坡[1] 于世勇[1] 武晓静[1] 赵刚[1] 晋军[1] 藤海军[1] 

机构地区：[1]解放军第三军医大学新桥医院全军心血管内科中心,重庆市400037

出　　处：《中国临床康复》2004年第21期4200-4202,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:探讨外源性肝细胞生长因子(hepatocytegrowthfactor,HGF)对心肌梗死后心肌细胞凋亡及左室重塑的影响。方法:将56只新西兰兔随机分为4组:假手术组、假手术+HGF组、对照组和干预组。结扎左冠状动脉前降支复制急性心肌梗死模型。干预组静脉注射给予HGF2mg/(kg·12h),4周后测心功能、左室重塑指标,取出心脏,梗死区/缺血区重量比为梗死范围。TUNEL法染色检测细胞凋亡。Westernblot法测定凋亡蛋白Bcl-2的表达。结果:与假手术组相比,对照组的左室舒张末容积、左室相对重量、左室壁厚度均显著升高(t=3.598,2.348,2.324,P<0.05～0.01),左室缩短分数(leftventricularfractionofshortening,LVFS)、左室射血分数(leftventricularejectionfraction,LVEF)均显著降低(t=4.311,3.330,P<0.01)。HGF干预组LVESV,LVEDV显著低于对照组(t=2.810,2.449,P<0.01);LVFS及LVEF均显著升高。HGF干预组细胞凋亡率、心肌梗死范围均低于对照组(t=2.302,2.344,P<0.01)。左室腔直径与心肌细胞凋亡率呈正相关(r=0.801,P<0.01)。干预组梗死心肌周围bcl-2表达(灰度值1.37)显著高于对照组(灰度值0.17)(t=21.043,P<0.01)。结论:HGF能减少心肌梗死范围、降低心肌细胞凋亡率并能限制心肌梗死后的左室重塑,改善心功能。AIM:To explore the effect of hepatocyte growth factor￡¨HGF￡(c)on cardiomyocyte apoptosis and left ventricular remodeling after acute myocardial infarction(AMI). METHODS:A total of 56 New Zealand rats were randomized into 4 groups:sham operation group,sham operation?HGF group,control group and intervention group.AMI model was established by ligating left coronary artery anterior descending branch.Animals in the intervention group were injected intravenously with HGF(2 mg/kg per 12 hours).After 4 weeks of ligation,cardiac function and left ventricle reconstructing index were measured.The heart was taken out and the ratio of infarction area to ischemia area was the infarction range.Cell apoptosis was detected by TUNEL straining,and the expression of bcl 2 protein was analyzed by western blot. RESULTS:Compared with the sham operation group,left ventricular end diastolic volume(LVESV),relative weight and wall thickness were all significantly increased￡¨t=3.598,2.348,2.324,P< 0.05￡-0.01￡(c),and the left ventricular fraction of shortening￡¨LVFS￡(c)and left ventricular ejection fraction(LVEF) were both decreased(t=4.311,3.330,P< 0.01).LVESV and LVEDV in the intervention group were significantly lower than those in the control group(t=2.810,2.449,P< 0.01);while LVFS and LVEF were increased greatly.Cell apoptotic rate and infarction size in HGF intervention group were significantly lower than that in the control group(t=2.302,2.344,P< 0.01).Left ventricular diameter was positively correlated with myocardial apoptotic rate(r=0.801,P< 0.01).The expression of bcl 2 protein(gray value was 1.37) in the intervention group was significantly higher than that in the control group(gray value was 0.17)(t=21.043,P< 0.01).CONCLUSION:HGF can reduce infarction area,decrease the rate of cardiomyocyte apoptosis,restrict the left ventricular remodeling after AMI and improve left ventricular function.The mechanism is probably associated with its antiapoptosis.

关 键 词：心肌梗死 心肌细胞凋亡 左室重塑 肝细胞生长因子 血流动力学 

分 类 号：R542.22[医药卫生—心血管疾病]