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目的:探讨血管内皮生长因子(VEGF)基因治疗心肌缺血是否有效。方法:构建真核表达载体质粒pcDNA3/VEGF121,然后将其直接注入兔左冠状动脉(冠脉)结扎的心肌;观察VEGF基因对缺血心肌侧支循环建立的影响。结果:在冠脉左前降支结扎48小时时,血清中谷草转氨酶、乳酸脱氢酶、磷酸肌酸激酶活性,VEGF基因组分别为(226.5±87.5)U/L,(3320.5±392.2)U/L,(530.0±48.3)U/L;与对照组〔分别为(202.4±107.9)U/L,(3180.6±304.7)U/L,(549.2±45.6)U/L〕比较相差不显著,P均>0.05。结扎2周时,VEGFmRNA表达则VEGF基因组明显高于对照组。心室前壁缺血区单位面积内的血管数VEGF基因组和对照组2周时分别为(48±11)条和(28±7)条,4周时为(108±29)条和(36±12)条,P<0.01。电镜观察以VEGF基因组血管增生明显,呈束状。结论:VEGF基因导入缺血心肌后,不仅表达,而且具有促进血管增生、增加侧支循环的生物效应
Objective: To investigate whether vascular endothelial growth factor (VEGF) gene is effective in treating myocardial ischemia. Methods: The eukaryotic expression plasmid pcDNA3 / VEGF121 was constructed and then directly injected into the left coronary artery (coronary artery) ligated myocardium. The effect of VEGF gene on the establishment of collateral circulation in ischemic myocardium was observed. Results: The activities of aspartate aminotransferase, lactate dehydrogenase, creatine phosphokinase and VEGF in the serum were (226.5 ± 87.5) U / L and (3320.5 ± 392.2 U / L and 530.0 ± 48.3 U / L, respectively. Compared with the control group [(202.4 ± 107.9) U / L, (3180.6 ± 304.7) U / L, (549.2 ± 45.6) U / L], the difference was not significant, P> 0.05. At 2 weeks after the ligation, VEGF mRNA expression was significantly higher in the VEGF gene group than in the control group. The numbers of blood vessels per unit area in the anterior wall of ventricles were (48 ± 11) and (28 ± 7) at 2 weeks and 108 ± 29 and (36 ± 12), P <0.01. Electron microscopy showed that the vascular endothelial growth factor (VEGF) CONCLUSION: VEGF gene is not only expressed but also has the biological effect of promoting vascular proliferation and increasing collateral circulation after its introduction into ischemic myocardium