目的:探讨有氧运动联合膳食控制对2型糖尿病大鼠心肌细胞凋亡的影响及其机制。方法:选用6周龄雄性SD大鼠62只,随机抽取8只大鼠作为正常对照组(C组),喂以标准饲料;其余54只在喂饲高脂高糖膳食的基础上,腹腔注射小剂量链脲佐菌素(STZ),建立2型糖尿病动物模型。然后将2型糖尿病大鼠随机分成4组:DM对照组(DM组,n=9)、DM+运动锻炼组(DME组,n=10)、DM+膳食控制组(DMD组,n=10)和DM+运动锻炼+膳食控制组(DMED组,n=10)。DM组大鼠继续喂饲高脂高糖饲料,不进行运动锻炼;运动锻炼采用每天60 min、每周6天的无负重游泳运动;膳食控制采用与DM组等量的标准饲料。12周后,检测各组大鼠空腹血糖(FPG)水平、心肌细胞凋亡指数、心肌组织Bcl-2和Fas含量。结果:①DM组心肌细胞凋亡指数和Fas含量显著高于C组(P<0.01),Bcl-2含量显著低于C组(P<0.05)。②通过双因素方差分析,有氧运动或膳食控制可以显著降低糖尿病大鼠心肌细胞凋亡指数和Fas含量(P<0.01),升高Bcl-2含量但无统计学意义(P>0.05),而有氧运动联合膳食控制对降低糖尿病大鼠心肌细胞凋亡指数和Fas含量、升高心肌组织bcl-2含量具有显著的交互作用(P<0.01)。结论:①糖尿病大鼠心肌细胞凋亡增加,而心肌组织Bcl-2含量降低和Fas含量升高可能是心肌细胞凋亡增加的重要机制。②长期有氧运动或膳食控制可以显著降低糖尿病大鼠心肌细胞凋亡,且有氧运动联合膳食控制对减少糖尿病大鼠心肌细胞凋亡具有显著交互作用。同时,升高心肌组织Bcl-2含量、降低心肌组织Fas含量可能是长期有氧运动联合膳食控制减少心肌细胞凋亡发生的重要机制。 Objective: To investigate the effects of aerobic exercise combined with dietary control on cardiomyocyte apoptosis in type 2 diabetic rats and its mechanism. Methods: Totally 62 male 6-week-old male Sprague-Dawley rats were randomly divided into normal control group (C group) and normal control group (C group). The other 54 rats were fed with high fat and high glucose diet, Small doses of streptozotocin (STZ), the establishment of type 2 diabetes animal model. The rats with type 2 diabetes were randomly divided into 4 groups: DM control group (DM group, n = 9), DM + exercise group (DME group, n = 10), DM + diet control group (n = 10) DM + exercise + diet control group (DMED group, n = 10). Rats in DM group were fed with high-fat and high-sugar diet continuously without exercise training. Exercise exercised daily for 60 min and no-load swimming for 6 days per week. Dietary control consisted of the same amount of standard feed as DM group. After 12 weeks, fasting plasma glucose (FPG) level, cardiomyocyte apoptosis index, myocardial Bcl-2 and Fas levels in each group were measured. Results ① The apoptosis index and Fas content of cardiomyocytes in DM group were significantly higher than those in C group (P <0.01). The content of Bcl-2 in DM group was significantly lower than that in C group (P <0.05). ②According to two-factor analysis of variance, aerobic exercise or dietary control could significantly reduce the apoptosis index and Fas content in diabetic rats (P <0.01), increase the content of Bcl-2 but had no statistical significance (P> 0.05) The combination of aerobic exercise and dietary control significantly reduced the apoptotic index and the content of Fas in diabetic rats, and increased the content of bcl-2 in myocardium (P <0.01). Conclusion: ①Apoptosis of myocardial cells in diabetic rats increased, and the decrease of Bcl-2 and the increase of Fas in myocardium may be the important mechanism of cardiomyocyte apoptosis. Long-term aerobic exercise or dietary control can significantly reduce myocardial apoptosis in diabetic rats, and aerobic exercise combined with dietary control to reduce myocardial apoptosis in diabetic rats had a significant interaction. At the same time, increasing Bcl-2 content and decreasing Fas content in myocardium may be an important mechanism of long-term aerobic exercise combined with dietary control to reduce cardiomyocyte apoptosis.