任爽,寇冠,郅季炘,等.干细胞移植联合抗阻训练对心肌梗死大鼠血管重塑的影响[J].中华物理医学与康复杂志,2025,47(10):874-881
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| 干细胞移植联合抗阻训练对心肌梗死大鼠血管重塑的影响 |
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| DOI：10.3760/cma.j.cn421666-20250326-00270 |
| 中文关键词: 抗阻训练 干细胞移植 心肌梗死 血管重塑 心功能 |
| 英文关键词: Resistance training Stem cell transplantation Myocardial infarction Vascular remodeling Cardiac function |
| 基金项目:河南省科技攻关项目(252102320267) |
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| 中文摘要: |
| 目的 探讨干细胞移植联合抗阻训练对心肌梗死大鼠血管重塑的影响，为临床治疗心肌梗死提供理论依据及治疗策略。 方法 采用随机数字表法将75只SD大鼠分为假手术组、模型组、干细胞组、训练组及联合组。通过结扎冠状动脉左前降支方式将模型组、干细胞组、训练组及联合组大鼠制成心肌梗死模型，术后干细胞组、训练组分别给予骨髓间充质干细胞（MSCs）移植或负重爬梯训练，联合组则同时给予MSCs移植及负重爬梯训练，干预时间均为8周。于末次运动结束后采用彩色多普勒超声诊断系统检测各组大鼠心脏结构、功能以及心肌血流量，通过HE和Masson染色观察心血管病理学改变，通过CD31免疫组化染色检测心脏毛细血管密度，采用Western blot法检测各组大鼠血管内皮生长因子（VEGF）、CD31、α-平滑肌肌动蛋白（α-SMA）及内皮型一氧化氮合酶（eNOS）蛋白表达量。 结果 与模型组比较，干细胞组、训练组及联合组大鼠的心脏结构、功能均显著改善，表现为左心室舒张末期内径（LVEDD）和左心室收缩末期内径（LVESD）减小（P<0.05），左室射血分数（LVEF）、左心室缩短分数（LVFS）、舒张早期充盈速度/舒张晚期充盈速度（E/A）比值及心脏血流量增加（P<0.05）；组织学观察显示，干细胞组、训练组及联合组毛细血管密度显著增加（P<0.05），胶原面积减小（P<0.05），心肌细胞病理性肥大得到改善（P<0.05）；分子生物学检测发现，干细胞组、训练组及联合组血管新生相关细胞因子（VEGF、CD31、α-SMA、p-eNOS）表达上调（P<0.05）；并且上述指标均以联合组的改善幅度尤为显著（P<0.05）。 结论 干细胞移植联合抗阻训练可有效改善心肌梗死大鼠血管重塑，并提升心功能，其疗效优于单独抗阻训练或干细胞移植治疗。 |
| 英文摘要: |
| Objective To explore the effect of combining resistance training with stem cell transplantation on vascular remodeling after myocardial infarction, so as to provide a theoretical basis and treatment for clinical use. Methods Seventy-five Sprague-Dawley rats were randomly divided into a sham operation group, a model group, a stem cell group, and a training and model combination group. All except the sham operation group underwent myocardial infarction modeling by ligation of the left anterior descending coronary artery. The stem cell group then received transplanted bone marrow mesenchymal stem cells (MSCs) and the training group performed weight-bearing ladder training. The combination group was given both interventions. The experiments lasted 8 weeks. At the end of the final exercise session, cardiac structure and functioning and myocardial blood flow were assessed using color Doppler ultrasound. Any pathological changes were observed through HE and Masson staining. Capillary density in the heart was determined via CD31 immunohistochemical staining. The expression levels of vascular endothelial growth factor (VEGF), CD31, α-smooth muscle actin (α-SMA), and endothelial nitric oxide synthase (eNOS) proteins were measured using western blotting. Results Compared with the model group, cardiac structure and function showed significant improvement in the stem cell, training and combination groups. This was manifested as decreased end-diastolic diameter and end-systolic diameter in the left ventricle, along with increased left ventricular ejection fraction, left ventricular fraction shortening, the ratio of early to late diastolic filling velocity, and myocardial blood flow. Histological examination revealed a significant increase in capillary density, reduced collagen area, and less pathological hypertrophy of cardiomyocytes in the stem cell, training and combination groups. In those groups there was also upregulation of angiogenesis-related cytokines (VEGF, CD31, α-SMA and p-eNOS). Notably, all these improvements were particularly pronounced in the combination group. Conclusion Resistance training combined with stem cell transplantation effectively improves vascular remodeling and enhances cardiac function after a myocardial infarction, at least in rats. The combination is more effective than either intervention alone. |
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