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目的:探讨胚胎干细胞移植结合透室壁性心肌血管重建术(transm yocardial revascularization,TMR)及血管内皮生长因子(vascular endothelial growth factor,VEGF)对大鼠心梗的修复作用。方法:制备实验性大鼠心梗模型,1周后实施TMR,术后10min于TMR微孔道凝血块内及其周围注射重组VEGF,孔周三点注射移植由绿色荧光蛋白标记的胚胎生殖细胞。4周后测量血液动力学指标评价心功能,并测量左心室重与体重之比,梗塞面积,毛细血管密度,评价移植区的组织学和形态学变化。结果:与单独移植细胞组相比,干细胞移植联合TMR、VEGF组心室肥大减轻,梗塞面积减少(P<0.01),梗塞区毛细血管密度增加(P<0.01),心功能明显改善(P<0.01)。结论:胚胎生殖细胞移植联合TMR、VEGF与单纯的细胞移植相比,能更有效地促进心梗区血管生成和移植细胞存活,改善梗塞心肌的心功能。
Objective: To investigate the effect of embryonic stem cell transplantation combined with transmyocardial revascularization (TMR) and vascular endothelial growth factor (VEGF) on myocardial infarction in rats. Methods: The rat model of myocardial infarction was prepared. One week later, TMR was performed. Recombinant VEGF was injected into and around the clot in the TMR microchannel 10 min after the operation. The green fluorescent protein-labeled embryonic germ cells were transplanted at the 3 o’clock of the hole. After 4 weeks, hemodynamic parameters were measured to evaluate the cardiac function. The ratio of left ventricular mass to body weight, infarct size and capillary density were measured to evaluate the histological and morphological changes. Results: Stem cell transplantation combined with TMR and VEGF reduced the infarction size and the area of infarction (P <0.01), the capillary density of infarction area increased (P <0.01) and the cardiac function improved significantly (P <0.01) ). Conclusion: Embryonic germ cell transplantation combined with TMR and VEGF can promote the angiogenesis and the survival of transplanted cells in myocardial infarction area and the cardiac function of myocardial infarction more effectively than simple cell transplantation.