【罂粟摘要】 体外冲击波对糖尿病大鼠血管病变的影响
体外冲击波对糖尿病大鼠血管病变的影响
背景：糖尿病是当今社会最常见的疾病之一。糖尿病可引起机体发生多种血管病变、肾功能不全、失明等。然而，关于体外冲击波治疗糖尿病血管疾病的作用的证据尚不足够。
方法：18名健康成年男性的雄性SD大鼠中被随机分为3组:正常对照组(A组)、糖尿病组(B组),和糖尿病+冲击波治疗组(C组),B组和C组腹腔注射链脲霉素60mg/kg，以建立糖尿病大鼠模型。C组对左下肢股动脉处各进行冲击波治疗1周(T1)、2周(T2)、3周(T3)、4周(T4)，其余2组正常饲养。T4冲击波治疗结束后，在电镜下观察各组股动脉。western blot检测血管内皮生长因子(VEGF)、内皮一氧化氮合酶(eNOS)、血管紧张素1型(AT1)的表达，实时聚合酶链反应检测VEGF表达变化。
结果：C组的VEGF和eNOS水平均高于B组(P <0.05)。B、C组大鼠的AT1水平明显高于A组(P <但C组明显低于B组(P <0.05)。经冲击波治疗后，C组血管内皮表面较B组平坦光滑，内皮基底膜及足突相对致密。
局限：本研究未进行血管功能障碍和糖尿病神经病变疼痛之间的潜在机制。
结论：冲击波可通过上调糖尿病大鼠VEGF、eNOS、下调AT1，促进新生血管形成，改善血管舒缩功能，在一定程度上改善血糖对血管的损害。
原始文献来源：Juan, Long, Chunjing, Hua, Ding, & Yue, et al. Effect of shock wave on vascular lesions in diabetic rats. Pain physician, (2019).22(5), E505-E510.
Effect of Shock Wave on Vascular Lesions in Diabetic Rats
Background: Diabetes is one of the most common diseases in today’s society. Diabetes can cause multiple vascular lesions in the body, renal insufficiency, blindness, and so on. However, the evidence concerning the role of extracorporeal shock wave therapy in diabetic vascular disease is insufficient. Objectives: Observation of the effect of shock wave on vascular lesions in diabetic rats. Study Design: This study used an experimental design. Setting: The research took place in the laboratory research center at The Third Military Medical University.
Methods: Eighteen healthy adult male Sprague Dawley rats were randomly divided into 3 groups: normal control group (group A), diabetic group (group B), and diabetes + shock wave treatment group (group C). Groups B and C were established by intraperitoneal injection of streptozotocin 60 mg/kg to demonstrate a diabetic rat model. Shock wave treatment was performed on the left lower extremity femoral artery in group C for 1 week (T1), 2 weeks (T2), 3 weeks (T3), and 4 weeks (T4) while the other 2 groups were reared normally. At the end of T4 shock wave treatment, the femoral arteries of each group were observed under an electron microscope. The expression of vascular endothelial growth factors (VEGF), endothelial nitric oxide synthase (eNOS), and angiotensin type 1 (AT1) were measured by western blot, and the changes of VEGF expression were detected by real-time polymerase chain reaction.
Results: The VEGF and eNOS in group C were higher than those in group B (P < 0.05). The AT1 of the rats in the B and C groups was significantly higher than that in the A group (P < 0.05), but the C group was significantly lower than the B group (P < 0.05). After shock wave therapy, the surface of vascular endothelium in group C was flatter and smoother than that in group B, and the endothelial basement membrane and foot process were relatively tight.
Limitations: Potential mechanisms that underlie the relationship between vascular dysfunction and diabetic neuropathy pain were not examined in this study.
Conclusions: Shock wave may promote the formation of new blood vessels and improve vasomotor function by upregulating VEGF, eNOS, and downregulation of AT1 in diabetic rats and improve the damage of blood glucose to blood vessels to some extent.
翻译：刘云琴 编辑：佟睿 审校：曹莹