糖尿病与非糖尿病冠心病患者骨髓间充质干细胞治疗大鼠急性心肌梗死的比较

Different cardioprotective function of transplantation of marrow mesenchymal stem cells from coronary heart disease patients with diabetes mellitus or not to acute myocardial infarction rats

目的比较糖尿病与非糖尿病的冠心病患者骨髓间充质干细胞（BMSCs）治疗大鼠急性心肌梗死的治疗效果。方法成年雄性大鼠45只，体质量0．28～0．30kg，数字表法随机分为糖尿病组、非糖尿病组、对照组，每组15只。制作急性心肌梗死模型，在心肌梗死区域分别注射来自糖尿病和非糖尿病患者的BMSCs和细胞培养液。观察并记录术后4周的超声心动图、凋亡相关蛋白Bcl-2和BAX的表达以及心肌细胞凋亡情况。结果糖尿病患者的BMSCs增殖能力明显低于非糖尿病患者。BMSCs移植后，糖尿病组与非糖尿病组大鼠的心脏功能及Bcl-2蛋白表达高于对照组；BAX蛋白表达、心肌细胞凋亡数量低于对照组。与非糖尿病组大鼠比较，糖尿病组大鼠的心脏功能、Bcl-2蛋白表达降低；BAX蛋白表达、心肌细胞凋亡数量增高。结论冠心病患者的BMSCs增殖能力较强，BMSCs移植可显著抑制心肌细胞凋亡，改善梗死后心脏功能。合并糖尿病可降低BMSCs增殖，抑制细胞凋亡，从而减弱其心肌保护作用。

Objective To evaluate the different cardioprotective function of transplantation of marrow mesenchymal stem cells（BMSCs） from coronary heart disease （CHD） patients with diabetes mellitus （DM） or not to myocardial infarction rats. Methods 45 adult male rats with acute myocardial infarction experimentally were randomized into three groups, 15 rats in each group. BMSCs from CHD patients with DM or not were injected into the infarcted myocardium. In control group, culture medium was used. Echocardiography, Western-blot analysis, TUNEL were performed 4 weeks after transplantation. Results Proliferation of BMSCs in DM group was significantly lower than that in non-DM group. Transplantation of BMSCs in the infarcted border zone improved cardiac function, Bcl-2 protein level in DM and non-DM group compared with control group, moreover, BAX protein level and TUNEL positive ceils were decreased. Furthermore, compared with uon-DM group, cardiac function and Bcl-2 protein level were decreased, however, BAX protein and TUNEL positive cells were improved. Conclusion BMSCs from CHD patients have proliferative properties. Transplantation of BMSCs can improve cardiac function by inhibiting apoptosis. But DM may decrease apoptosis resistance, which might impair the cardioprotective function of cells transplantation.