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体外冲击波疗法对糖尿病大鼠下肢血管病变的影响

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目的 观察体外冲击波疗法(ESWT)调节内皮细胞磷酸酶张力蛋白同源物(PTEN)的表达对糖尿病大鼠下肢血管病变的影响及其可能的机制。方法 将24只2月龄健康雄性SD大鼠随机分为3组:对照组(A组)、糖尿病血管病变组(B组)、糖尿病血管病变+ESWT治疗组(C组)。B组和C组采用高脂高糖喂养+腹腔注射链脲佐菌素60 mg/kg建立糖尿病血管病变大鼠模型,C组在建模成功后1周(T1)、2周(T2)、3周(T3)、4周(T4)接受ESWT治疗。T4时通过超声测量大鼠股动脉血管病变区血流速度和血管内径。ESWT治疗结束后即刻处死大鼠取下肢股动脉及腓肠肌,在电镜下观察各组股动脉结构。Western blot检测股动脉PTEN、磷脂酰肌醇-3-激酶(PI3 K)和蛋白激酶B(Akt)的表达水平,实时荧光定量逆转录-PCR(qRT-PCR)检测PTEN mRNA的表达水平;免疫荧光检测腓肠肌CD31表达水平。结果 B、C组T4时股动脉收缩期峰值流速及舒张末期血流速度均明显低于A组(P<0。05),但C组高于B组(P<0。05)。3组大鼠股动脉内径差异无统计学意义(P>0。05)。B、C组PTEN表达水平明显低于A组(P<0。05),但C组高于B组(P<0。05)。B组的PI3K、Akt表达水平均明显高于A组(P<0。05),C组低于B组(P<0。05)。B、C组PTEN mRNA表达水平明显低于A组(P<0。05),但C组高于B组(P<0。05)。电镜下观察到,ESWT治疗后,C组血管内皮细胞损伤较B组明显;B、C组CD31表达水平明显低于A组(P<0。05),但C组高于B组(P<0。05)。结论 ESWT可通过上调糖尿病大鼠下肢动脉PTEN,下调PI3K和Akt,改善血管功能,提高糖尿病大鼠股动脉收缩期峰值流速,改善腓肠肌微血管密度。
Effects of extracorporeal shock wave therapy on lower extremity vascular lesions in diabetic rats
Objective To observe the effect of extracorporeal shockwave therapy (ESWT) in regulating endothelial cell phosphatase and tensin homolog deleted on chromosome ten (PTEN) expression on lower ex-tremity vascular lesion and its possible mechanism.Methods Twenty-four 2-month-old healthy male SD rats were randomly divided into the three groups:control group (group A),diabetes angiopathy group (group B),diabetes angiopathy+ESWT group (group C).The group B and C were fed with high fat and high sugar and intraperitoneally injected with streptozotocin 60 mg/kg to establish the rat model of diabetes vascular lesion. The group C received ESWT at 1 week (T1),2 weeks (T2),3 weeks (T3) and 4 weeks (T4) after modeling,and the blood stream velocity of rat femoral artery vascular lesion area and vascular internal diameter were measured at T4 by ultrasound.At the end of ESWT,the rats were immediately killed for taking their femoral arteries and gastrocnemius.The structures of the femoral arteries in each group were observed under electron microscopy.Western blot was used to detect the expression levels of PTEN,PI3K and Akt proteins,while qRT-PCR was used to detect the expression levels of PTEN mRNA.Immunofluorescence was used to detect the expression level of CD31 in gastrocnemius muscle .Results The peak systolic flow velocity and end-dias-tolic flow velocity of femoral artery at T4 in group B and C were significantly lower than those in group A (P<0.05),but group C was higher than group B (P<0.05).The internal diameter of femoral artery had no statistical difference among 3 groups (P>0.05).The PTEN expression level in group B and group C was sig-nificantly lower than that in group A (P<0.05),while group C was higher than group B (P<0.05).The ex-pression levels of PI3K and Akt in group B were higher than those in group A (P<0.05),and group C was lower than group B (P<0.05).The PTEN mRNA expression level in group B and group C was significantly lower than that in group A (P<0.05),but group C was higher than group B (P<0.05).Under electron mi-croscopy,it was observed that after ESWT,the endothelial cell damage in group C was obvious when com-pared with group B.The CD31 expression level in group B and group C was significantly lower than that in group A (P<0.05),but group C was higher than group B (P<0.05).Conclusion ESWT could improve the vascular function,increase the peak velocity during systolic period of femoral artery in diabetes rats and im-prove the microvessel density of gastrocnemius muscle by up-regulating PTEN in lower extremity artery and down-regulating PI3K and Akt in diabetes rats.

extracorporeal shockwave therapydiabetesphosphatase and tensin homolog deleted on chromosome tenvascular endothelial cells

张柏巍、余倩、廖洪勇、张一弛、邹晋峰、贺纯静

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贵州医科大学麻醉学院,贵阳 550002

贵州省人民医院神经内科,贵阳 550000

贵州省人民医院超声科,贵阳 550000

贵州省人民医院烧伤整形科,贵阳 550000

贵州省人民医院疼痛科,贵阳 550000

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体外冲击波疗法 糖尿病 磷酸酶张力蛋白同源物 血管内皮细胞

2024

重庆医学
重庆市卫生信息中心,重庆市医学会

重庆医学

CSTPCD
影响因子:1.797
ISSN:1671-8348
年,卷(期):2024.53(14)