超声微泡靶向递送aFGF对糖尿病心肌病的治疗作用及其机制研究

 目的：观察SonoVue超声微泡靶向递送酸性成纤维细胞生长因子（aFGF）对糖尿病心肌病（DCM）大鼠左室舒缩功能的保护作用并初步探讨其机制。方法：24只健康雄性SD大鼠通过腹腔注射链脲佐菌素建立DCM模型，再随机平均分成DCM组与aFGF治疗组。另选择正常对照组12只。aFGF治疗组经尾静脉注射SonoVue-aFGF溶液并同时给予心肌定点超声辐照。干预后4周对所有大鼠行心导管检查，测定左室收缩末压力(LVESP)、左室舒张末压力(LVEDP)和左室内压最大上升/下降速率(LV±dp/dtmax)。处死大鼠取心肌组织，免疫组织化学染色检测心肌微血管密度（MVD)，改良Masson胶原染色法测定心肌胶原容积分数（CVF），TUNEL法检测心肌组织凋亡指数（AI）。结果：干预后4周，aFGF治疗组大鼠LVESP和LV±dp/dtmax与DCM组比较明显增加（P<0.01）,LVEDP较DCM组明显减低（P<0.01）。aFGF治疗组MVD测值与DCM组比较明显增加（P<0.01）,而CVF及AI较DCM组明显减低（P<0.01）。结论: 超声微泡靶向递送aFGF可有效改善DCM大鼠的左心室功能，有望成为治疗DCM的新方法。

Protective effect of aFGF delivery by ultrasound-targeted microbubble destruction on left ventricular function in diabetic cardiomyopathy rats

AIM：To observe the protective effect of delivery of acidic fibroblast growth factor (aFGF) to myocardium by ultrasound-targeted microbubble destruction (UTMD) on left ventricular function in diabetic cardiomyopathy (DCM) rats and to investigate the possible mechanisms. METHODS：Twenty-four rats were intraperitoneally injected with streptozocin to induce DCM and were randomly divided into DCM group and aFGF treatment group. Twelve healthy rats served as normal controls. The rats in aFGF treatment group were infused with SonoVue-aFGF mixed fluid through tail vein and UTMD was simultaneously performed. Four weeks after intervention, all rats underwent cardiac catheterization to mea-sure left ventricular end-systolic pressure (LVESP), left ventricular end-diastolic pressure (LVEDP) and the maximal increase/decrease rate of left ventricular pressure (LV±dp/dtmax). The microvessel density (MVD) of rat myocardial tissues was measured by immunohistochemical staining for CD31. The myocardial collagen volume fraction (CVF) was determined by improved Masson staining. The apoptotic index (AI) was detected by TUNEL method. RESULTS：Four weeks after intervention, the LVESP and LV±dp/dtmax in aFGF treatment group were significantly increased compared with DCM group (P<0.01), while the LVEDP in aFGF treatment group was significantly lower than that in DCM group (P<0.01). The MVD in aFGF treatment group was significantly increased compared with DCM group (P<0.01), but the CVF and AI in aFGF treatment group were significantly lower than those in DCM group (P<0.01). CONCLUSION: Delivery of aFGF to diabetic myocardium by UTMD could improve the left ventricular function of DCM rats and may be a new feasible therapeutic method for DCM.