大网膜包裹自体心房组织联合移植对慢性心肌梗死大鼠心功能的影响  

Effect of Omentopexy Combining Autologous Atrial Tissue Patch Cardiomyoplasty for Treating the Chronic Myocardial Infarction in Experimental Rats

作　　者：侯剑峰[1] 张昌伟[1] 郑哲[1] 胡盛寿[1] 

机构地区：[1]中国医学科学院北京协和医学院国家心血管病中心阜外心血管病医院心血管疾病国家重点实验室,北京市100037

出　　处：《中国循环杂志》2014年第12期1015-1019,共5页Chinese Circulation Journal

基　　金：国家国际科技合作项目(2010DFA32620);北京市科技新星计划(Z111107054511080);协和青年科研基金项目(2013XHQN03)

摘　　要：目的:探讨大网膜包裹自体心房组织联合移植对慢性心肌梗死大鼠心脏功能的影响。方法:前降支结扎法建立大鼠心肌梗死模型,3周后将筛选合格的模型动物随机分为4组:对照组,仅再次开胸;心耳组,开胸后裁取左心耳组织移植于心肌梗死及周边区;大网膜组:经膈肌将大网膜移植于心肌梗死及周边区;联合移植组:分别移植左心耳组织和大网膜。手术4周后,超声心动图评价心脏功能,Masson染色检测心肌梗死面积和疤痕厚度,免疫组化评价心耳存活、血管化,蛋白免疫印迹法检测血管内皮生长因子(VEGF)、金属蛋白酶(MMP-2/MMP-9)及其抑制物(TIMP-3)蛋白表达,明胶酶谱法评价金属蛋白酶活性。结果:4周后,左心耳组织仅在联合移植组存活。Masson染色显示各组心肌梗死面积差异无统计学意义(P>0.05),联合移植组疤痕厚度显著增厚(391±31)μm vs(329±33)μm,P<0.05;超声心动图结果证实联合移植组心脏功能显著改善[左心室射血分数(:57.9±5.8)%vs(47.5±4.5)%,P<0.05和左心室短轴缩短率(:25.2±3.6)%vs(20.7±2.0)%,P<0.05];免疫组化结果显示大网膜组及联合移植组梗死周边区血管密度明显增加[(49/0.2 mm2 vs 33/0.2 mm2 and48/0.2 mm2 vs 33/0.2 mm2),P<0.01];蛋白免疫印迹法显示金属蛋白酶在联合移植组表达下降,金属蛋白酶抑制物表达差异无统计学意义,明胶酶谱法证实联合移植组金属蛋白酶活性下降(MMP-2:68%,P=0.002;MMP-9:64%,P=0.016),差异均有统计学意义。结论:大网膜能通过增强血管化促进心房组织的存活,联合移植能通过改善胶原重构途径改善慢性心肌梗死大鼠心脏功能。Objective： To explore the effect of omentopexy combining autologous atrial tissue patch cardiomyoplasty for treating the chronic myocardial infarction（MI） in experimental rats.Methods： The MI model of SD rats was established by left coronary artery ligation. 3 weeks later, the qualified animals were randomized into 4 groups for the 2nd operation. 1 Control group, the rats only received re-thoracotomy, 2 Atrial appendage group, the autologous atrial tissue patch was harvested from left atrial appendage of rats and transplanted to infarcted zone, 3 Omentum group, the omentum of rats was transplanted to infarcted zone through diaphragm and 4 Combination group, the left atrial appendage tissue and omentum were transplanted to infarcted zone together. 4 weeks after the 2nd operation, the cardiac function was evaluated by echocardiography, the size and scar thickness of the infarction were examined by Masson staining, the survival of transplanted atrial tissue and angiogenesis were measured by immunohistochemistry, the protein expressions of VEGF, MMPs and TIMP-3 were examined by Western blot analysis, and the activities of MMPs wereidentified by gelatin zymography.Results： 4 week after the 2nd operation, transplanted left atrial appendage tissue only survived in Combination group.The areas of infarction were similar among different groups, P0.05. Compared with Control group, Combination group had the increased scar thickness（329 ± 33） μm vs（391±31） μm, improved LVEF（47.5 ± 4.5） % vs（57.9 ± 5.8） %, improved LVFS（20.7 ± 2.0） % vs（25.2 ± 3.6） %, all P0.05. Compared with Control group, both Omentum group and Combination group demonstrated higher density of angiogenesis at infracted area（33/0.2） mm2 vs（49/0.2） mm2 and（33/0.2） mm2 vs（48/0.2）mm2, all P0.01. Combination group had decreased protein expressions of MMPs, while the expressions of TIMP-3 were similar among different groups, the activities of MMP-2 and MMP-9 were decreased by 68%, P=0.002 and 64%, P=0.016 re

关 键 词：心肌梗死 大网膜包裹 

分 类 号：R54[医药卫生—心血管疾病]