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目的:对比观察糖尿病(DM)大鼠心肌梗死(MI)后非梗死区域心肌肥大、增殖分化和细胞凋亡的改变,探讨DM对MI后心室重构的影响。方法:将实验大鼠分为正常对照组、糖尿病对照组、MI对照组及糖尿病MI组,从各组大鼠的左心室梗死周边取材,采用免疫组化染色法检测转化生长因子-β1(TGF-β1)、增殖细胞核抗原(PCNA),用末端脱氧核苷酸转移酶介导的dUTP末端缺口标记法(TUNEL)检测凋亡细胞,并进行对比分析。结果:DM大鼠MI后非梗死区域存在着明显的心肌肥大、增殖分化和细胞凋亡。试验表明,糖尿病MI组大鼠梗死区周边凋亡细胞及PCNA、TGF-β1的阳性率均明显高于DM对照组及MI对照组(P<0.01)。DM对照组大鼠梗死区周边凋亡细胞的比例明显高于MI对照组(P<0.01)。结论:DM可增强TGF-β1和PCNA的表达及增加细胞凋亡,三者可能为DM大鼠MI后高心律失常及高死亡率的病理生理基础。
Objective: To compare the changes of myocardial hypertrophy, proliferation, differentiation and apoptosis after myocardial infarction (MI) in diabetic rats and to investigate the effect of DM on ventricular remodeling after MI. Methods: The experimental rats were divided into normal control group, diabetic control group, MI control group and diabetic MI group. The left ventricular infarcts of the rats in each group were harvested and the expressions of transforming growth factor - β1 (TGF - β1) β1) and proliferating cell nuclear antigen (PCNA) were detected by flow cytometry. Apoptotic cells were detected by terminal deoxynucleotidyl transferase mediated dUTP nick end labeling (TUNEL). Results: There was significant myocardial hypertrophy, proliferation and differentiation and apoptosis in non-infarcted area of DM rats. The results showed that the positive rate of apoptotic cells, PCNA and TGF-β1 in DM group were significantly higher than those in DM group and MI control group (P <0.01). The proportion of apoptotic cells in infarcted area in DM control group was significantly higher than that in MI control group (P <0.01). Conclusion: DM can enhance the expression of TGF-β1 and PCNA and increase apoptosis, all of which may be pathophysiological basis of high arrhythmia and high mortality in MI rats.