SonoVue微泡介导转染Ang-1基因治疗急性心肌梗死

目的 探讨SonoVue微泡介导转染血管生成素-1(Ang-1)基因治疗急性心肌梗死的可行性.方法 27只中国家兔结扎冠状动脉左回旋支制成急性心肌梗死模型后随机分为4组:第1组(n=7,注射微泡+Ang-1+超声照射组)、第2组(n=7,单纯注射微泡+超声照射组)、第3组(n=7,单纯注射Ang-1+超声照射组)、第4组(n=6,空白对照组),于基因转染前后分别行常规超声心动图检查及心肌声学造影,并于处死后取心肌组织行RT-PCR检测Ang-1 mRNA表达.结果 第1组基因转染后2周常规超声心动图示左室射血分数(LVEF)显著提高(P<0.01),心功能改善,心肌声学造影可见术后充盈缺损处出现片状造影剂回声,RT-PCR可检测出Ang-1 mRNA表达,余各组则无明显心功能改善及造影剂充填,RT-PCR亦无法检测出Ang-1表达.结论 超声微泡可介导Ang-1基因成功转染至缺血心肌,改善缺血心肌微循环及心功能,对急性心肌梗死具有治疗作用.

SonoVue delivering Ang-1 to ischemic myocardium in acute myocardial infarction

Objective To investigate the feasibility of Ang-1 gene delivery to ischemic myocardium in acute myocardial infarction with ultrasound contrast agent SonoVue. Methods Twenty-seven rabbits ligation models of left circumflex branch coronary artery were divided into 4 groups randomly as group 1 (n=7, accepted intravenous injection of SonoVue and Ang-1), group 2 (n=7, accepted intravenous injection of SonoVue only), group 3 (n=7, accepted intravenous injection of Ang-1 only) and group 4 (n=6, without any treatment). Myocardial contrast echocardiography (MCE) and conventional echocardiography examination were performed on all animals before and after the treatment. All rabbits were killed after 2 weeks and examined for Ang-1 mRNA with RT-PCR. Results Microbubble could be observed in group 1 in MCE examination, while contrast agent echo was defected obviously in group 2, 3 and 4. Group 1 showed significantly improvement in the ejection fraction (P<0.01) while other three groups did not. Ang-1 mRNA could be detected in group 1, but in none of the animals in other groups. Conclusion Microbubbles can deliver Ang-1 gene to ischemic myocardium. The transplantation can improve the perfusion of acute myocardial infarction and the function of heart.