【摘要】 目的确定穿心室壁内支架联合血管内皮生长因子基因治疗在猪急性心肌梗死(AMI)模型中的治疗作用。方法中国小型猪30头随机分为四组:心肌梗死组(MI);支架组(ST);内皮生长因子基因组(VEGF)和支架+基因组(ST+VEGF)。MI组采用结扎冠状动脉左前降支形成AMI模型,其余三组在形成梗死模型后分别采用穿心室壁支架置入、直接心肌内注射携带hVEGF165的质粒载体以及联合治疗。4周后行心脏超声、心肌血管密度检测和免疫组化等检查。结果4周后ST组、VEGF组、ST+VEGF组的血管密度均明显多于MI组,其中ST+VEGF组与其他各组比较在促进血管生长方面有明显优势(P<0．01)。VEGF组和ST+VEGF组较MI组在VEGF蛋白表达方面明显提高。结论穿心室壁内支架联合VEGF治疗综合了支架形成通道、机械刺激促进血管生成以及携带促血管生成因子基因的载体的输送作用,提供了一种比任何单独治疗心肌梗死技术更有效的手段。更多还原

【Abstract】 Objectives To determine the efficacy of combined use of transmyocardial stent with gene therapy to treat acute myocardial infarction in porcine model. Methods 24 Chinese mini swines have been devided into 4 groups randomly: group myocardial infarction (group MI n1=6) , group transmyocardial stent (group ST n2=6 ) , group vascular endothelial growth factor (group VEGF n3=6), group transmyocardial stent and VEGF(group ST + VEGF n4=6). In group MI, acute myocardial infarction animal model has been established by the ligation of the left descending coronary artery. In group ST, after the establishment of the model, 3 transmyocardial stents were implanted. In group VEGF, an expression plasmid containing the gene-encoding VEGF165(300μg)was administered directly in the myocardium at 6 sites. In group ST + VEGF, both transmyocardial stents and expression plasmid containing the gene-encoding VEGF165 are applied. 4 weeks later, the animals are sacrificed and echocardiography and pathological analysis have been done. Results The density of blood vessel in group ST, VEGF and ST + VEGF are significantly higher than group MI. And capillary density in group ST + VEGF is the highest in these groups statistically. Expression of VEGF was detected in group ST,VEGF and ST + VEGF, but in group VEGF and ST + VEGF the level of expression are higher. Conclusion Combined use of transmyocardial stent with gene therapy has synthetic effect for the treatment of acute myocardial ischemia in porcine model and can significantly increase the vascular density.更多还原