左心辅助循环对慢性心衰心肌炎症细胞因子及基质胶原代谢的影响

The Research on the Recovery Mechanisms of Cardiac Function for Goat Chronic Heart Failure After Left Ventricular Mechanical Assist

目的通过建立羊慢性心衰（chronic heart failure，CHF）动物模型以及心衰后应用国产心室辅助装置辅助循环，测定心肌肿瘤坏死因子α（tumor necrosis factor-α，TNF-α），白细胞介素1，6（interleukin-6，1β，IL-6，1β），膜型基质金属蛋白酶1（membrane typel-matrix metalloprotease，MT1-MMP）的变化，探讨心室辅助治疗后心衰心肌功能恢复的有关分子机制。方法通过快速右心室内膜起搏4～5周建立羊慢性心衰动物模型10只，随机分为对照组和实验组各5只，实验组行左心辅助（left ventricular assist devices，LVAD）循环治疗（36±8）h，辅助结束后两组动物开胸取左心室心尖组织液氮速冻后-70℃保存。两组心肌组织行TNF-α和MT1-MMP荧光定量逆转录聚合酶链式反应检测（quantitative reverse transcription-polymerized chain reaction, QRT-PCR），IL-6，IL-1β行半定量逆转录聚合酶链式反应检测（RT-PCR），同时做TNF-α，胶原Ⅰ、Ⅲ免疫组化染色。结果与对照组比较，心室辅助循环后实验组心肌TNF-α，TI1-MMP mRNA水平明显降低（P〈0．01），IL-6，IL-1βmRNA水平也明显下降（P〈0．05），免疫组化染色显示心肌细胞体积减少，TNF-α，collagenⅠ染色明显降低（P〈0．05）。结论心室辅助循环能减低慢性心衰心肌组织TNF-α、TI1-MMP、IL-6、IL-1βmRNA表达水平以及TNF-α，胶原Ⅰ蛋白合成水平，抑制不利的心肌重塑，改善心肌功能。

Objectives To examine the levels of cardiac tissue TNF-α, IL-6, IL-β, MT1-MMP mRNA and made the immunohistochemistry stain of TNF-α and collagen Ⅰ、Ⅲ in goat chronic heart failure after left ventricular mechanical assist. Methods After establishment of goat CHF by rapid right ventricular pacing for 4-5weeks, we make LVAD support therapy on this CHF model for about 36 hours. After this procedure, TNF-α, IL-6, IL-β, MT1-MMP mRNA level of 2 groups were detected by reverse transcription-polymerized chain reaction （RT-PCR） and TNF-α and collagen Ⅰ、Ⅲ protein level were checked by immunohistochemistry stain. Results Compared with control group, left ventricular assist group had decrease cardiac tissue levels of TNF-α, IL-6, IL-β, MT1-MMP mRNA and protein expressions （ P 〈 0.01, 0.05）. ConclusionsThe application of left ventricular assist devices in chronic heart failure can reduce TNF-α, TI1-MMP, IL-6, IL-1β mRNA expression levels and TNF-α, collagen Ⅰ protein synthesis levels of cardiac tissue, inhibit unfavourable cardiac remodeling, and improve cardiac function of CHF.