肝细胞生长因子对犬心肌梗死后二尖瓣反流的影响  

Effect of Hepatocyte Growth Factor on Mitral Regurgitation Caused by Acute Myocardial Infarction in Canines

作　　者：冯斌[1] 杨庭树[1] 李萍[1] 李岩密[1] 梁丽玲[1] 

机构地区：[1]解放军总医院心内科,北京市100853

出　　处：《中国康复理论与实践》2009年第4期301-303,F0003,共4页Chinese Journal of Rehabilitation Theory and Practice

基　　金：军队"十五"重点课题资助(No.01Z036)

摘　　要：目的探讨肝细胞生长因子(HGF)对犬急性心肌梗死后二尖瓣反流的影响。方法将13只杂种犬结扎左冠状动脉前降支复制急性心肌梗死模型,并将造模成功的12只犬随机分为对照组和治疗组各6只。治疗组于梗死心肌周围注射pc-DNA3-HGF1ml(约300μg),对照组给予等量生理盐水。分别于术后1、4、8周进行超声心动图检查,监测心功能;术后8周测量左心房面积、二尖瓣反流面积以及二尖瓣反流面积与左心房面积的比值。处死犬,取心肌组织行HE染色、Ⅷ因子免疫组化染色及TUNEL染色,应用图像分析系统测定血管个数及凋亡细胞数。结果术后4周时,治疗组左心室射血分数(LVEF)高于对照组(P<0.05);8周时,治疗组LVEF明显升高,左心室收缩末容积(LVESV)较对照组降低(P<0.05),且左心房面积、二尖瓣返流面积以及二尖瓣返流面积与左心房面积的比值均低于对照组(P>0.05)。HE染色可观察到治疗组梗死心肌周围毛细血管较对照组增多,而对照组瘢痕形成明显。Ⅷ因子免疫组化染色显示治疗组梗死边缘区毛细血管明显多于对照组(P<0.01)。TUNEL染色显示与对照组相比,治疗组梗死边缘区凋亡细胞减少(P>0.05)。结论HGF可能通过增加梗死心肌周围毛细血管数目,减少细胞凋亡,使心肌坏死及疤痕形成减少,从而缓解急性心肌梗死时的心功能恶化、左心房扩大及二尖瓣反流。Objective To investigate the effect of hepatocyte growth factor （HGF） on mitral regurgitation caused by acute myocardial infarction in canines. Methods The acute myocardial infarction model was established by ligating proximal left anterior descending coronary artery （LAD） with 13 hybrid canines. The myocardial infarction model was successfuly established in 12 animals and those were randomly divided into the HGF group and control group with 6 animals in each group. Canines of the HGF-group were injected with pc-DNA3 HGF 1 ml （about 300μg） at the margin of infarcted myocardial and animals of the control group were injected with equal volume saline. The data were measured through echocardiography in the 1st, 4th and 8th week after ligation as following parameters： left ventricular ejection fraction （LVEF）, left ventricular end-systolic volume （LVESV）, left atrial area, mitral regurgitation area and the ratio of left atrial area to mitral regurgitation area. Left ventricular myocardium specimens were obtained in the 8th week after ligation and stained with hematoxylin and eosin for histological examination or with picrosirius red staining to assess the collagen content. Results Compared with the control group, LVEF in the HGF-group increased in the 4th week af ter ligation; LVEF significantly improved and LVESV decreased in the 8th week after ligation （ P〈0.05）. In the 8th week after ligation, left atrial area, mitral regurgitation area and the ratio of left atrial area to mitral regurgitation area in the HGF-group were lower than that in the control group. In the HGF group, neovascularization and fewer scars were observed histologically. Compared with the control group, the HGF-group showed higher capillary density in margin of infarcted area by factor Ⅷ-related immunohistochemistry staining （ P〈0.01）. Conclusion HGF gene can improve cardiac function and relieve mitral regurgitation after acute myocardial infarction by stimulating angiogenesis, reducing fibrosis, diminishing my

关 键 词：肝细胞生长因子 心肌梗死 心功能 二尖瓣反流 

分 类 号：R542.2[医药卫生—心血管疾病]