摘要
目的探讨体外心脏震波联合六氟化硫微泡后处理对心肌缺血再灌注损伤(MI/RI)大鼠的心肌保护作用,为临床治疗MI/RI提供理论支持。方法将32只雄性SD大鼠均分为4组:假手术组(Sham组)、MI/RI组(IR组)、体外心脏震波治疗(CSWT)组(IR+SW组)和CSWT联合六氟化硫微泡治疗组(IR+SW+MB组),每组8只。IR+SW组及IR+SW+MB组在造模后第1 d、第3 d及第5 d进行治疗干预。在治疗前及治疗后应用超声心动图测量各组大鼠左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室射血分数(LVEF)、左心室短轴缩短率(LVFS)。所有大鼠于第7 d取材,应用Masson染色观察心肌纤维化,TUNEL染色观察心肌细胞凋亡。应用Western blot检测梗死边界区心肌凋亡指标Bcl-2、BAX、激活Caspase-3和激活Caspase-9蛋白的表达水平。比较各组间以上指标的差异。结果①治疗前及治疗后各组间大鼠心律及心率无明显变化,心率差异无统计学意义(P>0.05)。②治疗后超声心动图结果显示,与IR组比较,IR+SW组、IR+SW+MB组LVEDD及LVESD依次减小,LVEF及LVFS依次升高,组间两两比较差异有统计学意义(均P<0.05)。③与IR组比较,IR+SW组、IR+SW+MB组心肌纤维化及凋亡程度依次减轻,以IR+SW+MB组减轻最明显。定量分析显示,与IR组比较,IR+SW组、IR+SW+MB组心肌细胞凋亡比例依次减少,组间两两比较差异有统计学意义(均P<0.05)。④Western blot检测结果显示,与IR组比较,IR+SW组、IR+SW+MB组Bcl-2水平依次升高,BAX水平及Caspase-3、Caspase-9蛋白的活化水平依次降低,组间两两比较,除IR+SW组与IR+SW+MB组Caspase-3蛋白的活化水平差异无统计学意义(P>0.05),余组间比较差异有统计学意义(均P<0.05)。结论CSWT联合六氟化硫微泡治疗可抑制心肌细胞凋亡,改善左心室重构,提高左心室收缩功能。
Objective To investigate the myocardial protective effect of extracorporeal cardiac shock wave therapy(CSWT)combined with sulfur hexafluoride microbubble post-conditioning on myocardial ischemia-reperfusion injury(MI/RI)in rats,and to provide theoretical support for clinical treatment of MI/RI.Methods A total of 32 male SD rats were randomly divided into 4 groups:sham operation group(Sham group),MI/RI group(IR group),CSWT group(IR+SW group),and CSWT combined with sulfur hexafluoride microbubble treatment group(IR+SW+MB group),with 8 rats in each group.Therapeutic intervention was performed in IR+SW group and IR+SW+MB group on the 1st,3rd and 5th day after modeling.The left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular ejection fraction(LVEF)and left ventricular fractional shortening(LVFS)of the rats were measured by echocardiography before and after treatment.On the 7th day,myocardial fibrosis was assessed by Masson staining,and cardiomyocyte apoptosis was observed by TUNEL staining.The myocardial apoptotic proteins Bcl-2,BAX,Cleaved-Caspase-3 and Cleaved-Caspase-9 in the infarct boundary area were detected by Western blot.The differences of the above indexes among different groups were compared.Results①There was no significant change in heart rhythm and heart rate among the groups before and after treatment,and there was no significant difference in heart rate(P>0.05).②The echocardiographic results after treatment showed that,compared with IR group,LVEDD and LVESD in IR+SW group and IR+SW+MB group decreased in turn,while LVEF and LVFS increased in turn with significant differences between each two groups(all P<0.05).③Compared with IR group,the degrees of myocardial fibrosis and apoptosis in IR+SW group and IR+SW+MB group were alleviated in turn,and the relief in IR+SW+MB group was the most obvious.Quantitative analysis showed that compared with IR group,the proportions of cardiomyocyte apoptosis in IR+SW group and IR+SW+MB group decreased in turn,and there were significant differences between each two groups(all P<0.05).④The results of Western blot detection showed that compared with IR group,the levels of Bcl-2 in IR+SW group and IR+SW+MB group increased in turn,while the levels of BAX and the activation level of Caspase-3 and Caspase-9 protein decreased in turn.These differences were all statistically significant between each two groups(all P<0.05)except for the activation level of Caspase-3 protein between IR+SW group and IR+SW+MB group(P>0.05).Conclusions CSWT combined with sulfur hexafluoride microbubble therapy can improve left ventricular remodeling and left ventricular systolic function by inhibiting cardiomyocyte apoptosis.
作者
苗雅敬
薛雅宁
王晓旭
周虹
韩高洁
呼海娟
韩若凌
尹洪宁
Miao Yajing;Xue Yaning;Wang Xiaoxu;Zhou Hong;Han Gaojie;Hu Haijuan;Han Ruoling;Yin Hongning(Department of Echocardiography,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China;Department of Cardiology,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China;Department of Ultrasound,the Fourth Hospital of Hebei Medical University,Shijiazhuang 05001l,China)
出处
《中华超声影像学杂志》
CSCD
北大核心
2024年第1期77-84,共8页
Chinese Journal of Ultrasonography
基金
河北省重点研发计划项目(20377762D)
河北省医学科学研究课题计划(20221118)。
关键词
体外心脏震波
六氟化硫微泡
心肌缺血再灌注损伤
凋亡
Extracorporeal cardiac shock wave
Sulfur hexafluoride microbubbles
Myocardial ischemia-reperfusion injury
Apoptosis
