目的通过观察地高辛(Digoxin)干预血管紧张素Ⅱ(AngⅡ)诱导的ApoE-/-小鼠高血压性心肌肥厚模型后,对G蛋白调节因子2(regulator of G protein signaling 2,RGS2)的影响,探讨地高辛治疗高血压性心肌肥厚的作用与可能的机制。方法 30只雄性ApoE-/-小鼠随机分为对照组、AngⅡ模型组和AngⅡ+Digoxin治疗组。所有小鼠从术前1d至术后处死前均接受0.5%二甲基亚砜或地高辛溶液腹腔注射治疗,并且在术后28d获取心脏组织,通过组织学检查、苏木精-伊红(HE)染色切片分析技术评定心肌组织形态学变化、RGS2的mRNA及蛋白表达水平来评价地高辛的作用。结果与AngⅡ模型组相比,AngⅡ+Digoxin组全心重量、左心室壁厚度、心肌细胞直径均明显减少(P<0.05或P<0.01),RGS2mRNA变化不明显,而蛋白表达增高(P<0.01),心肌肥厚明显减轻。同时检测小鼠在术前3d,手术当天,术后3、7、14、28d的血压,发现AngⅡ+Digoxin组与AngⅡ模型组比较,术后7d和14d血压下降(均P<0.05),术后28d则差异无统计学意义。结论地高辛可能通过上调ApoE-/-小鼠高血压心肌肥厚模型RGS2的表达,有效减轻心肌肥厚,这说明地高辛可能在抑制心肌细胞肥大中起重要作用。
Clinically,coronary artery bypass grafting (CABG)or percutaneous coronary intervention (PCI)is generally used to treat patients with ischemic heart failure.However, the optimal treatment strategy remains unknown.This study examined the efficacy of the two coronary revascularization strategies for severe ischemic heart failure by using a meta-analysis.Studies comparing the efficacy of CABG and PCI were obtained from PubMed,EMBASE,Google Scholar and Cochrane Central Register of Controlled Trials (CENTRAL).The quality of each eligible article was evaluated by Newcastle-Ottawa Quality Assessment Scale (NOS),and the meta-analysis was performed using Stata version 12.0 software.Eventually,12 studies involving 9248 patients (n=4872 in CABG group;n=4376 in PCI group)were subject to the meta-analysis for subsequent pooling calculation.The pooled hazard ratio (HR)[HR=0.83,95%CI (0.76,0.90),P<0.001; heterogeneity,P=0.218,I^2=22.9%]of CABG compared with that of PCI revealed a statistical superiority of CABG to PCI in terms of the long-term mortality.Furthermore, CABG showed more advantages over PCI with respect to the incidence of myocardial infarction [HR=0.51,95%CI (0.39,0.67),P<0.001;heterogeneity,P=-0.707,I^2=0%]and repeat revascularization [HR=0.40,95%CI (0.27,0.59),P<0.001;heterogeneity,P<0.001, I^2=80.1%].It was concluded that CABG appears to be more advantageous than PCI for the treatment of ischemic heart failure in the given clinical setting.
Jie XIAOFen XUChuan-lei YANGWei-qiang CHENXing CHENHua ZHANGZhan-jie WEIJin-ping LIU
