激光心肌血运重建术联合血管内皮细胞生长165基因治疗缺血心肌的研究

The experimental study on CO 2 laser in combined with vascular e ndothelial growth factor 165 gene in the treatment of myocardial ischemia in dog s

目的 观察激光心肌血运重建术 (TMLR )联合血管内皮细胞生长因子 16 5基因(VEGF16 5cDNA)治疗缺血心肌后心肌血管密度、心肌灌注和代谢的变化。方法 健康杂种犬 48条 ,随机分为TMLR组、TMLR联合VEGF16 5cDNA组和空质粒 (pcDNA3 .1)组 (n =12 ) ,心肌梗死为对照组。结扎冠状动脉致心肌缺血 6 0min后行CO2 激光心肌打孔 ,VEGF16 5cDNA基因转染采用直接心肌注射法。结果 TMLR联合VEGF16 5基因治疗后 6和 12周 ,缺血区心肌血管密度和心肌灌注量、代谢显著高于TMLR组。结论 TMLR联合VEGF16 5基因治疗缺血心肌后心肌血管密度显著增加 ;成活心肌的数量显著增加和 /或成活心肌功能显著恢复。

Objective To determine the changes of v as cular density and metabolism and myocardial perfusion of ischemic myocardium aft er TMLR in combination with intramyocardial administration VEGF165 cDNA. WT5'H Z Methods Forty-eight dogs were randomly divided into TMLR gr oup,TMLR in combination with plasmid VEGF165cDNA group,pcDNA3.1 group and contr ol group (myocardial infarction,n=12 in each).Results The vascular density and the amount of perfusion and intake of FDG in TMLR in combination with VEGF165 gene plasmid group were greate r than those of TMLR group at 6th week and 12th week after gene therapy,respect ively.Conclusion Combined use of TMLR with VEGF165 gene f or ischemic myocardium can significantly increase the vascular density and the n umber of viable myocardium,and/or improve the function of viable myocardium.