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目的观察针刺心肌打孔(TNP)心肌血运重建术(TMR)后新生血管的变化及血管内皮生长因子(VEGF)、碱性成纤维细胞生长因子(bFGF)和转移生长因子β(TGF-β)在缺血心肌的表达,探讨TNP心肌血运重建术的可能机制。方法开胸结扎16只犬冠状动脉左前降支,建立急性心肌缺血模型。以单纯缺血为对照组(n=8),实验组(n=8)行针刺心肌打孔。两组动物分别于术后1、2、4、8周分批处死,利用组织切片HE染色法观察心肌血管密度,并通过免疫组化抗原染色法观察VEGF、bFGF和TGF-β的变化,于显微镜下行计算机扫描计算每高倍视野显色面积(μm2/HP)。结果实验组VEGF的表达在术后2周达高峰,bFGF和TGF-β的表达则在术后1周达高峰,而心肌血管密度在术后4周达高峰。实验组各时相VEGF、bFGF和TGF-β平均蛋白表达水平及平均心肌血管密度分别明显高于对照组(P<0.05或P<0.01)。结论血管生长相关因子(如VEGF,bFGF和TGF-β)表达水平的升高可能是TNP诱导血管新生的主要作用机制之一。
Objective To observe the changes of neovascularization after cardiac revascularization (TMR) and the expressions of vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF) and transforming growth factor β (TGF- β) in ischemic myocardium to explore the possible mechanism of TNP myocardial revascularization. Methods Thoracotomy was performed to ligate the left anterior descending coronary artery of 16 dogs to establish acute myocardial ischemia model. Simple ischemic control group (n = 8), experimental group (n = 8) acupuncture cardiac perforating. The animals in two groups were sacrificed at 1, 2, 4 and 8 weeks after operation. The myocardial vascular density was observed by HE staining. The changes of VEGF, bFGF and TGF-β were observed by immunohistochemical staining. Microscope downlink computer scan calculated per high power field color area (μm2 / HP). Results The expression of VEGF in experimental group reached its peak at 2 weeks after operation, the expression of bFGF and TGF-β peaked at 1 week after operation, and the peak of myocardial vascular density peaked at 4 weeks after operation. The average protein expression of VEGF, bFGF and TGF-β and the average myocardial vascular density in experimental group were significantly higher than those in control group at each time point (P <0.05 or P <0.01). Conclusion The increased expression of vascular growth factors (such as VEGF, bFGF and TGF-β) may be one of the main mechanisms of TNP-induced angiogenesis.