体外冲击波疗法对糖尿病大鼠下肢血管病变的影响  

Effects of extracorporeal shock wave therapy on lower extremity vascular lesions in diabetic rats

作　　者：张柏巍 余倩[2] 廖洪勇 张一弛 邹晋峰[5] 贺纯静[5] ZHANG Bowei;YU Qian;LIAO Hongyong;ZHANG Yichi;ZOU Jinfeng;HE Chunjing(School of Anesthesiology,Guizhou Medical University,Guiyang,Guizhou 550002,China;Department of Neurology,Guizhou Provincial People’s Hospital,Guiyang,Guizhou 550000,China;Department of Ultrasound,Guizhou Provincial People’s Hospital,Guiyang,Guizhou 550000,China;Department of Burn and Plastic Surgery,Guizhou Provincial People’s Hospital,Guiyang,Guizhou 550000,China;Department of Pain,Guizhou Provincial People’s Hospital,Guiyang,Guizhou 550000,China)

机构地区：[1]贵州医科大学麻醉学院,贵阳550002 [2]贵州省人民医院神经内科,贵阳550000 [3]贵州省人民医院超声科,贵阳550000 [4]贵州省人民医院烧伤整形科,贵阳550000 [5]贵州省人民医院疼痛科,贵阳550000

出　　处：《重庆医学》2024年第14期2092-2098,共7页Chongqing medicine

基　　金：国家自然科学基金项目(82260453);贵州省科技厅项目(黔科协科委科〔2022〕271,黔科协科委科〔2021〕403);贵州省卫生健康委员会科学技术基金项目(gzwkj2023-167)。

摘　　要：目的观察体外冲击波疗法(ESWT)调节内皮细胞磷酸酶张力蛋白同源物(PTEN)的表达对糖尿病大鼠下肢血管病变的影响及其可能的机制。方法将24只2月龄健康雄性SD大鼠随机分为3组:对照组(A组)、糖尿病血管病变组(B组)、糖尿病血管病变+ESWT治疗组(C组)。B组和C组采用高脂高糖喂养+腹腔注射链脲佐菌素60 mg/kg建立糖尿病血管病变大鼠模型,C组在建模成功后1周(T_(1))、2周(T_(2))、3周(T_(3))、4周(T_(4))接受ESWT治疗。T_(4)时通过超声测量大鼠股动脉血管病变区血流速度和血管内径。ESWT治疗结束后即刻处死大鼠取下肢股动脉及腓肠肌,在电镜下观察各组股动脉结构。Western blot检测股动脉PTEN、磷脂酰肌醇-3-激酶(PI3K)和蛋白激酶B(Akt)的表达水平,实时荧光定量逆转录-PCR(qRT-PCR)检测PTEN mRNA的表达水平;免疫荧光检测腓肠肌CD31表达水平。结果B、C组T_(4)时股动脉收缩期峰值流速及舒张末期血流速度均明显低于A组(P<0.05),但C组高于B组(P<0.05)。3组大鼠股动脉内径差异无统计学意义(P>0.05)。B、C组PTEN表达水平明显低于A组(P<0.05),但C组高于B组(P<0.05)。B组的PI3K、Akt表达水平均明显高于A组(P<0.05),C组低于B组(P<0.05)。B、C组PTEN mRNA表达水平明显低于A组(P<0.05),但C组高于B组(P<0.05)。电镜下观察到,ESWT治疗后,C组血管内皮细胞损伤较B组明显;B、C组CD31表达水平明显低于A组(P<0.05),但C组高于B组(P<0.05)。结论ESWT可通过上调糖尿病大鼠下肢动脉PTEN,下调PI3K和Akt,改善血管功能,提高糖尿病大鼠股动脉收缩期峰值流速,改善腓肠肌微血管密度。Objective To observe the effect of extracorporeal shockwave therapy(ESWT)in regulating endothelial cell phosphatase and tensin homolog deleted on chromosome ten(PTEN)expression on lower extremity vascular lesion and its possible mechanism.Methods Twenty-four 2-month-old healthy male SD rats were randomly divided into the three groups:control group(group A),diabetes angiopathy group(group B),diabetes angiopathy+ESWT group(group C).The group B and C were fed with high fat and high sugar and intraperitoneally injected with streptozotocin 60 mg/kg to establish the rat model of diabetes vascular lesion.The group C received ESWT at 1 week(T_(1)),2 weeks(T_(2)),3 weeks(T_(3))and 4 weeks(T_(4))after modeling,and the blood stream velocity of rat femoral artery vascular lesion area and vascular internal diameter were measured at T_(4)by ultrasound.At the end of ESWT,the rats were immediately killed for taking their femoral arteries and gastrocnemius.The structures of the femoral arteries in each group were observed under electron microscopy.Western blot was used to detect the expression levels of PTEN,PI3K and Akt proteins,while qRT-PCR was used to detect the expression levels of PTEN mRNA.Immunofluorescence was used to detect the expression level of CD31 in gastrocnemius muscle.Results The peak systolic flow velocity and end-diastolic flow velocity of femoral artery at T_(4)in group B and C were significantly lower than those in group A(P<0.05),but group C was higher than group B(P<0.05).The internal diameter of femoral artery had no statistical difference among 3 groups(P>0.05).The PTEN expression level in group B and group C was significantly lower than that in group A(P<0.05),while group C was higher than group B(P<0.05).The expression levels of PI3K and Akt in group B were higher than those in group A(P<0.05),and group C was lower than group B(P<0.05).The PTEN mRNA expression level in group B and group C was significantly lower than that in group A(P<0.05),but group C was higher than group B(P<0.05).Under electron mic

关 键 词：体外冲击波疗法 糖尿病 磷酸酶张力蛋白同源物 血管内皮细胞 

分 类 号：R493[医药卫生—康复医学]