【摘要】 目的观察经冠状静脉窦逆行灌注血管内皮生长因子基因(pAdtrackCMV-VEGF₁₆₅)对兔心肌梗死模型左心室心肌组织基质金属蛋白酶（MMP 1,2）及其组织抑制因子（TIMP1,2）表达的影响。方法20只新西兰大白兔随机分为基因治疗组和对照组,两组动物常规全麻,气管插管,胸骨正中切开,暴露心脏,结扎左室支建立心肌梗死模型,冠状静脉窦插管,基因治疗组逆行灌注pAdtrackCMV-VEGF₁₆₅,对照组以生理盐水对照,全程记录心电,于结扎左室支前及结扎后6h取冠状静脉窦血4mL备测CK、CK-MB及TnT。4周后处死动物,取左心室前壁心肌检测MMP 1,2、TIMP 1,2表达情况,并计算TIMP1/MMP1比值。结果对照组1只动物于术后1d死亡,基因治疗组所有动物全部存活;结扎后即刻可见左室前壁及心尖部颜色变暗,搏动减弱,心电图出现ST段抬高并与T波融合;结扎后6h CK、CK-MB及TnT均显著高于结扎前（P<0.05或0.01）;基因治疗组MMPI表达增强（P<0.05）,TIMP 1、MMP 2及TIMP 2表达与对照组差异无显著,TIMP 1/MMP 1明显低于对照组（P<0.01）。结论经冠状静脉窦逆行灌注pAdtrackCMV-VEGF₁₆₅可调节基质金属蛋白酶及其组织因子表达,改善梗死后心室重塑。更多还原

【Abstract】 Objective To investigate the effect of VEGF gene transfer on matrix metalloproteinases （MMPs） and tissue inhibitors of metalloproteinases （TIMPS） expression by coronary sinus retrograde perfusion with pAdtrackCMV-VEGF₁₆₅ in rabbit myocardial infarction model.Methods Twenty New Zealand rabbits were divided into 2 groups,general anesthesia and open thorax,elevating the apex of the heart,clamping the main stem of left ventricular coronary,pAdtrackCMV-VEGF₁₆₅ were retrograde perfused trough coronary sinus in experiment group,and nature saline were used in control group.Expression of MMP1,2 and TIMP1,2 were detected 4 weeks later.The ratio of TIMP1/ MMP1 was calculated.Results One animal died of heart failure in control group and all animal survived in gene treatment group.The expression of MMP1 were lower in control group （P<0.05）.The ratio of TIMP1/MMP1 were significantly higher in control group than that in gene treatment group （P< 0.05）.Conclusion Coronary sinus retrograde perfusing with pAdtrackCMV-VEGF₁₆₅ can modulate the expression of MMPs and TIMPs,thus,improve ventrencle remodeling.更多还原