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目的探讨B族维生素在酒精性心肌病(alcoholic cardiomyopathy,ACM)发病中的作用。方法 106只Wistar大鼠随机分为乙醇组41只,观察组37只和对照组28只。乙醇组和观察组随意饮用体积分数10%乙醇及体积分数60%乙醇灌胃制备ACM模型,观察组同时给予维生素B612mg/(kg·d)、维生素B120.09mg/(kg·d)、叶酸4mg/(kg·d),对照组饮用水及等量生理盐水灌胃,3组均喂养24周。分别于入组及喂养8、16、24周时行超声检查,测定左心室舒张末期内径(left ventricular end-diastolic dimension,LVEDd)、左室射血分数(left ventricular ejection fraction,LVEF)、左心室短轴缩短率(fractional shortening,FS),采用化学发光法测定血浆同型半胱氨酸(homocysteine,Hcy)水平,并计算心肌组织基质金属蛋白酶(matrix metalloprotein-9,MMP-9)及胶原纤维含量。结果喂养24周时乙醇组大鼠左心腔扩大,室壁厚度变薄,超声心动图符合ACM改变,提示造模成功;喂养16、24周时,乙醇组LVEDd[(6.87±0.55)、(7.54±0.49)mm]、观察组LVEDd[(5.70±0.60)、(7.13±0.41)mm]较对照组宽[(4.75±0.39)、(4.72±0.32)mm](P<0.05),乙醇组LVEF[(51.81±8.16)%、(43.24±5.41)%]、观察组LVEF[(62.79±7.91)%、(48.50±5.86)%]低于对照组[(78.07±3.77)%、(76.93±4.73)%],乙醇组FS[(30.51±2.72)%、(21.94±2.94)%]、观察组FS[(37.29±4.12)%、(24.57±3.14)%]低于对照组[(46.81±2.39)%、(44.95±3.38)%](P<0.05);喂养16周时乙醇组LVEDd较观察组宽(P<0.05),LVEF、FS低于观察组(P<0.05);喂养8、16、24周时观察组血浆Hcy水平[(4.54±1.53)、(4.93±1.63)、(5.16±2.03)μmol/L]低于对照组[(9.99±2.59)、(10.00±3.10)、(10.41±2.40)μmol/L]和乙醇组[(18.12±3.08)、(26.31±4.03)、(30.87±3.63)μmol/L](P<0.05),对照组低于乙醇组(P<0.05);喂养16、24周时,乙醇组[(0.160 9±0.019 0)%、(0.262 5±0.013 6)%]、观察组[(0.116 4±0.021 6)%、(0.245 5±0.025 4)%]MMP-9表达水平高于对照组[(0.054 5±0.006 8)%、(0.055 9±0.008 3)%](P<0.05),且喂养16周时观察组MMP-9表达低于乙醇组(P<0.05);喂养16、24周时乙醇组胶原纤维表达[(0.102 3±0.012 0)%、(0.224 1±0.025 7)%]、观察组胶原纤维表达[(0.074 5±0.009 2)%、(0.202 0±0.044 5)%]高于对照组[(0.005 2±0.000 9)%、(0.005 5±0.000 9)%](P<0.05),且喂养16周时观察组胶原纤维表达低于乙醇组(P<0.05)。结论补充B族维生素可能通过降低血浆Hcy水平来而延缓ACM发病。
Objective To investigate the role of B vitamins in the pathogenesis of alcoholic cardiomyopathy (ACM). Methods 106 Wistar rats were randomly divided into ethanol group 41, observation group 37 and control group 28. The ACM model was prepared by intragastric administration of 10% ethanol and 60% ethanol in the ethanol group and the observation group. The observation group was given vitamin B612mg / (kg · d), vitamin B120.09mg / (kg · d), folic acid 4mg / (kg · d), the control group drinking water and the same amount of saline, 3 groups were fed for 24 weeks. The left ventricular end-diastolic dimension (LVEDd), left ventricular ejection fraction (LVEF), left ventricular short axis The fractional shortening (FS) was measured. The level of plasma homocysteine (Hcy) was measured by chemiluminescence and the content of matrix metalloprotein-9 (MMP-9) and collagen fibers was calculated. Results At 24 weeks of feeding, the left ventricular cavity was enlarged and the thickness of the ventricular wall was thinned. The echocardiography was consistent with the changes of ACM, which suggested that the model was successful. At 16 and 24 weeks of feeding, LVEDd [(6.87 ± 0.55), (4.75 ± 0.39), (4.72 ± 0.32) mm] (P <0.05) in the observation group and in the ethanol group (7.54 ± 0.49) mm] LVEF in the observation group [(62.79 ± 7.91)%, (48.50 ± 5.86)%] was lower than that in the control group [(78.07 ± 3.77)%, (76.93 ± (37.59 ± 4.12)%, (4.73)%] in the ethanol group and the FS [(30.51 ± 2.72)%, (21.94 ± 2.94)%] in the ethanol group were significantly lower than those in the control group [(46.81 ± (P <0.05); LVEDd in ethanol group was significantly longer than that in observation group (P <0.05); LVEF and FS were lower than those in observation group (P <0.05) The levels of Hcy in the observation group at 24 weeks and 24 weeks [(4.54 ± 1.53), (4.93 ± 1.63), (5.16 ± 2.03) μmol / L] were lower than those in the control group (9.99 ± 2.59, 10.00 ± 3.10, 10.41 ± 2.40) μmol / L] and ethanol group [(18.12 ± 3.08), (26.31 ± 4.03), (30.87 ± 3.63) μmol / L] At 16 and 24 weeks of feeding, the alcohol group [(0.160 9 ± 0.019 0)%, (0.262 5) The expression of MMP-9 in the observation group was significantly higher than that in the control group [(0.054 5 ± 0.006 8)%, (0.055 9 ±) 0.016 6%, and (0.116 4 ± 0.021 6)%, (0.245 5 ± 0.025 4)%] (P <0.05), and the expression of MMP-9 in the observation group was lower than that in the ethanol group at 16 weeks of feeding (P <0.05); at 16 and 24 weeks of feeding, the expression of collagen fiber in the ethanol group [(0.102 3 ± 0.012 0 ) And (0.224 ± 0.025 7)%, respectively. The expression of collagen fibers in the observation group [(0.074 5 ± 0.009 2)%, (0.202 ± 0.044 5)%] was higher than that in the control group , (0.005 5 ± 0.000 9)%] (P <0.05), and the expression of collagen fibers in the observation group was lower than that in the ethanol group at 16 weeks of feeding (P <0.05). Conclusions Supplementing B vitamins may delay the onset of ACM by decreasing plasma Hcy levels.