目的研究外源性胰岛素对糖尿病大鼠缺血后肢血管内皮生长因子(VEGF)表达的影响及其促血管新生的作用。方法取20只健康雄性SD大鼠,将其右后肢股动、静脉及其分支和属支结扎,制成糖尿病大鼠后肢缺血模型,然后将其用简单随机化方法随机平均分为模型组与治疗组,另取10只正常大鼠作为对照组。14 d后处死大鼠,应用Western blot法检测大鼠后肢肌肉组织中VEGF蛋白表达水平,并采用碱性磷酸酶(AKP)染色法测定大鼠后肢肌肉组织中毛细血管密度。结果对照组大鼠术前和术后7 d体重和血糖水平比较差异无统计学意义(P>0.05);模型组大鼠术后7 d与术前比较,体重明显下降(P<0.05),但血糖水平差异无统计学意义(P>0.05);而治疗组给予皮下注射胰岛素注射液术后7 d较术前体重明显下降,并且血糖水平较术前也明显下降,差异均有统计学意义(P<0.05)。与对照组比较,治疗组及模型组大鼠术后7 d体重明显下降、血糖明显升高(P<0.05,P<0.01);治疗组与模型组比较,体重差异无统计学意义(P>0.05),但治疗组大鼠术后7 d血糖水平较模型组明显降低(P<0.05)。治疗组大鼠缺血肢体肌肉组织中VEGF蛋白相对表达量(155.06±10.26)明显高于模型组(94.30±11.23),P<0.05;对照组大鼠未检测到VEGF蛋白表达。对照组大鼠右后肢肌肉组织中毛细血管密度明显高于模型组和治疗组(P<0.05),而治疗组又明显高于模型组(P<0.05)。3组大鼠左后肢毛细血管密度差异无统计学意义(P>0.05);对照组大鼠左、右后肢毛细血管密度差异无统计学意义(P>0.05);模型组和治疗组大鼠右后肢毛细血管密度均明显低于左后肢(P<0.05)。结论胰岛素可以增强糖尿病大鼠后肢缺血肌肉组织中VEGF蛋白表达,促进毛细血管生成,发挥保护作用。 Objective To investigate the effect of exogenous insulin on the expression of vascular endothelial growth factor (VEGF) in ischemic hindlimb of diabetic rats and its effect on angiogenesis. Methods Twenty healthy male Sprague-Dawley rats were used to ligate the right hindlimb femoral vein, branches and branches of the hind limbs to establish a model of hindlimb ischemia in diabetic rats. The rats were randomly divided into model group And treatment group, another 10 normal rats as control group. The rats were killed after 14 days. Western blot was used to detect the expression of VEGF protein in the hindlimb muscle tissue of rats. AKT staining was used to determine the capillary density in the hindlimb muscle of rats. Results There was no significant difference in body weight and blood glucose level between pre-operation and post-operation 7 d in control group (P> 0.05). At 7 d after operation in model group, body weight decreased significantly (P <0.05) But there was no significant difference in blood glucose level between the two groups (P> 0.05). In the treatment group, the subcutaneous injection of insulin injection significantly decreased body weight at 7 days and the blood glucose level also decreased significantly compared with that before operation (P <0.05). Compared with the control group, the weight of the rats in the treatment group and the model group decreased significantly on the 7th day after operation and the blood glucose was significantly increased (P <0.05, P <0.01). There was no significant difference in body weight between the treatment group and the model group (P> 0.05). However, the blood glucose level of the treatment group was significantly lower than that of the model group on the 7th day (P <0.05). The relative expression of VEGF protein in the ischemic limb muscle tissue in the treatment group (155.06 ± 10.26) was significantly higher than that in the model group (94.30 ± 11.23), P <0.05. No VEGF protein expression was detected in the control group. The density of capillary in right hind limb muscle of control group was significantly higher than that of model group and treatment group (P <0.05), while the treatment group was significantly higher than that of model group (P <0.05). There was no significant difference in capillary density of the left hind limbs between the three groups (P> 0.05). There was no significant difference in the capillary density of the left and right hind limbs in the control group (P> 0.05) Hind limb capillary density was significantly lower than the left hind limb (P <0.05). Conclusion Insulin can enhance the expression of VEGF protein in ischemic hindlimb muscle tissue of diabetic rats and promote capillary angiogenesis and play a protective role.