兰州大学机构库 >第二临床医学院
达格列净对急性心肌梗死小鼠心室晚期重构影响的机制研究
Alternative TitleMechanistic study on the effect of dagliflozin on late ventricular remodeling in mice with acute myocardial infarction
邢策
Subtype硕士
Thesis Advisor白锋
2021-05-25
Degree Grantor兰州大学
Place of Conferral兰州
Degree Name医学硕士
Degree Discipline内科学
Keyword心肌梗死 心室重构 达格列净 TGF-β 磷酸化p38
Abstract目的:心力衰竭是心血管疾病的终末阶段,逐渐成为全球重要公共卫生问题,急性心肌梗死是心衰最常见的病因,急性心肌梗死后患者心衰的发病率高,随着心梗治疗的不断进展,心梗后心衰的发病率出现向下的趋势。心室重构是急性心肌梗死后心衰的基本病理过程,由病理性心肌细胞肥大、凋亡、成纤维细胞增生和纤维化共同驱动。纤维化是导致晚期重构的重要表型,大量的心肌纤维化改变导致心腔扩大,心肌顺应性降低,心功能下降。钠-葡萄糖转运体2抑制剂本身是一种有效的降糖药物,却能够使心衰患者获益,减轻心室重构,然而SGLT2抑制剂减轻心室重构的机制尚不明确。本研究通过小鼠体内实验探究了SGLT2抑制剂达格列净对小鼠急性心肌梗死后心室重构及TGF-β表达、p38磷酸化水平的影响。 方法:将47只C57健康雄性小鼠随机分成4组,第一组正常组(Control)n=11,第二组假手术组(Sham)n=11,第三组手术组(MI)n=14,第四组达格列净干预组+MI(DAPA+MI)n=11,control组不做处理,sham组只开胸不结扎冠脉,MI组开胸结扎冠脉,DAPA+MI组开胸结扎冠脉。DAPA+MI组达格列净(1mg/kg/day)灌胃,另外3组每天等量生理盐水灌胃,术前及术后四周采用超声心动图检测各组小鼠心功能指标(LVEF、LVFS)和左心室结构指标(LVEDD、LVESD、LVEDV、LVESV)六组数据的变化;采用ELISA方法检测血浆NT-proBNP、TGF-β的浓度变化;采用HE染色检测各组心肌细胞的改变,马松染色检测各组心肌纤维化程度;采用免疫组化对TGF-β和磷酸化p38蛋白表达进行定位及半定量分析,采用蛋白印迹法对TGF-β和磷酸化p38蛋白表达进行定量分析。 结果:术后四周,control组和sham组相比较,心功能及心脏结构、炎症细胞渗出、心脏纤维化面积没有明显差异(p>0.05),血清NT-proBNP、TGF-β的浓度没有明显差异(p>0.05),心肌组织中TGF-β、磷酸化p38的表达没有明显差异(p>0.05),MI组与control组比较心功能指标(LVEF、LVFS)明显下降(p<0.05),左心室结构指标(LVEDD、LVESD、LVEDV、LVESV)四组数据明显增大(p<0.05),血浆NT-proBNP、TGF-β浓度明显升高(p<0.05),炎性细胞渗出、心肌纤维化程度明显上升(p<0.05),心肌组织中TGF-β、磷酸化p38的表达明显增加(p<0.05);DAPA+MI组与MI组相比较心功能指标(LVEF、LVFS)明显上升(p<0.05),左心室结构指标(LVEDD、LVESD、LVEDV、LVESV)四组数据明显减小(p<0.05),血浆NT-proBNP、TGF-β浓度明显降低(p<0.05),炎症细胞渗出、心肌纤维化程度明显下降(p<0.05),心肌组织中TGF-β、磷酸化p38的表达明显减少(p<0.05); 结论:达格列净能够明显改善急性心肌梗死小鼠的心功能,减轻左心室扩大,抑制心肌纤维化改变,减少梗死心肌炎症反应,减少心肌细胞坏死、水肿,减少炎症细胞的浸润,还能够下调TGF-β表达,降低p38磷酸化水平。以上研究结果表明达格列净能够改善小鼠急性心肌梗死后心室重构,此作用可能与降低TGF-β表达、抑制p38磷酸化有关。
Other AbstractObjective: Heart failure is the final stage of cardiovascular disease, gradually becoming an important global public health problem, acute myocardial infarction is the most common cause of heart failure, the incidence of heart failure patients after acute myocardial infarction is high, with the continuous progress of the treatment of myocardial infarction, the incidence of heart failure after myocardial infarction has a downward trend.Ventricular remodeling is the basic pathological process of heart failure after acute myocardial infarction, which is driven by pathological cardiomyocyte hypertrophy, apoptosis, fibroblast proliferation and fibrosis.Fibrosis is an important phenotype leading to late remodeling. A large number of myocardial fibrosis changes lead to enlarged heart cavity, decreased cardiac compliance, and decreased cardiac function.Sodium glucose transporter 2 inhibitors themselves are an effective hypoglycemic agent, but they can benefit patients with heart failure and reduce ventricular remodeling. However, the mechanism by which SGLT2 inhibitors reduce ventricular remodeling remains unclear.In this study, the effects of SGLT2 inhibitor dagliquin on ventricular remodeling, TGF-βexpression and p38 phosphorylation in mice after acute myocardial infarction were investigated in vivo. Methods: Forty-seven C57 healthy male mice were randomly divided into four groups: the first normal control group (control) n=11, the second sham-operated group (Sham) n=11, the third surgical group (MI) n=14, the fourth dagliflozin intervention + MI group (DAPA+MI) n=11, the control group was left untreated, the sham group was opened and ligated without coronary artery only, and the other three groups were opened and ligated with coronary artery. In the DAPA+MI group, dagliflozin (1 mg/kg/day) was administered by gavage, and in the other three groups, saline was administered in equal amounts daily. Six groups of data were examined;ELISA was used to detect the changes of plasma NT-proBNP and TGF-βconcentrations;HE staining was used to detect the changes of cardiomyocytes in each group, and Masson staining was used to detect the degree of myocardial fibrosis in each group;immunohistochemistry was used to detect the changes of TGF-βand phosphorylated p38 positive area, and protein blotting was used to detect the TGF-βand phosphorylated p38 protein expression changes. Results: Four weeks after surgery, there were no significant differences in cardiac function and cardiac structure, inflammatory cell exudation, and cardiac fibrosis area in the control group compared with the sham group (p>0.05), no significant differences in the concentrations of serum NT-proBNP and TGF-β(p>0.05), and no significant differences in the expression of TGF-βand phosphorylated p38 in myocardial tissue (p>0.05) ;LVEF and LVFS were significantly decreased in MI group compared with control group (p <0.05), LVEDD, LVESD, LVEDV and LVESV data were significantly increased in four groups (p <0.05), plasma NT-proBNP and TGF-βconcentrations were significantly increased (p <0.05), inflammatory cell exudation and myocardial fibrosis were significantly increased (p <0.05), and the expression of TGF-βand phosphorylated p38 in myocardial tissue was significantly increased (p <0.05);LVEF and LVFS were significantly increased in the DAPA+MI group compared with the MI group (p <0.05), and the data of four groups, LVEDD, LVESD, LVEDV and LVESV, were significantly reduced (p <0.05), and plasma NT-proBNP, TGF-βconcentrations were significantly lower (p <0.05), inflammatory cell exudation and myocardial fibrosis were significantly lower (p <0.05), and the expression of TGF-βand phosphorylated p38 in myocardial tissue was significantly lower (p <0.05). Conclusion: Dapagliflozin can improve ventricular remodeling after acute myocardial infarction in mice. Long-term administration of dapagliflozin can significantly improve the cardiac function of acute myocardial infarction mice, reduce left ventricular enlargement, inhibit myocardial fibrosis, and reduce infarct myocarditis. Symptomatic response, reducing myocardial cell necrosis and edema, reducing the infiltration of inflammatory cells, down-regulating the expression of TGF-β, and reducing the level of p38 phosphorylation. The above research results indicate that dapagliflozin can improve ventricular remodeling after acute myocardial infarction in mice, and this effect may be related to the reduction of TGF-βexpression and inhibition of p38 phosphorylation.
Pages67
URL查看原文
Language中文
Document Type学位论文
Identifierhttps://ir.lzu.edu.cn/handle/262010/460939
Collection第二临床医学院
Affiliation第二临床医学院
First Author AffilicationSecond Clinical School
Recommended Citation
GB/T 7714
邢策. 达格列净对急性心肌梗死小鼠心室晚期重构影响的机制研究[D]. 兰州. 兰州大学,2021.
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