扩张型心肌病家兔血浆脑钠肽水平的改变及其意义  

Change in content of plasma brain natriuretic peptide in dilatatory cardiomyopathy in rabbit

作　　者：李文强[1] 李艳[2] 魏捷[1] 李国草[3] 李庚山[3] 

机构地区：[1]武汉大学人民医院急诊科,430060 [2]武汉大学人民医院检验科,430060 [3]武汉大学人民医院心内科,430060

出　　处：《中国危重病急救医学》2005年第3期161-164,共4页Chinese Critical Care Medicine

基　　金：湖北省卫生厅科研基金资助项目 (NX2 0 0 413 )

摘　　要：目的　观察实验性阿霉素扩张型心肌病 (DCM)模型家兔血浆脑钠肽 (BNP)的改变 ,并探讨其意义。方法　 2 2只健康家兔随机分为正常对照组 (n=10 )和 DCM模型组 (n=12 ) ,经兔耳缘静脉注射盐酸阿霉素 8周建立 DCM模型。分别于给药前及给药后第 8周和第 11周进行超声心动图、血浆 BNP水平检测 ,第11周测定血流动力学指标并观察心肌病理学改变。结果　模型组动物的超声心动图、血流动力学指标及病理学变化符合 DCM的病理改变。模型组给药前的血浆 BNP水平与正常对照组比较差异无显著性 (P>0 .0 5 ) ;用药后血浆 BNP水平显著增高 (P均 <0 .0 1) ,第 11周的血浆 BNP水平显著高于第 8周 (P<0 .0 5 )。血浆BNP水平与左室舒张末期容积 (L VEDV)、左室收缩末期容积 (L VESV)、左室舒张末期压 (L VEDP)均呈显著正相关关系 ,与左室内压峰值 (L VSP)和左室射血分数 (L VEF)均呈负相关关系。结论　阿霉素 DCM模型适合于研究衰竭心脏神经内分泌异常 ;心室负荷和室壁张力的增加是调节 BNP分泌的关键因素 ;血浆 BNP水平是评价 DCM心功能损伤严重程度的良好指标。Objective To determine the changes in plasma brain natriuretic peptide (BNP) in adriamycininduced dilatatory cardiomyopathy (DCM) in rabbit, and to evaluated the significance. Methods Twentytwo rabbits were randomly divided into control group ( n=10 ) and model group( n =12). The DCM model was reproduced by injecting adriamycin via ear vein for 8 weeks. Echocardiogram was performed and plasma BNP were measured before administration, and at 8 th and 11 th week after the challenge. Indexes of hemodynamics and pathological changes were observed. Results Indexes of echocardiogram and hemodynamics of model group were consistent with pathologic changes of DCM. Plasma levels of BNP of the model group were increased significantly after administration of the drug(all P <0 01), though the values before the drug administration were approximately the same as in the control group. Plasma BNP levels were significantly higher in DCM group at the 11 th week than at the 8 th week( P <0 05). Plasma levels of BNP were positively correlated with and left ventricular enddiastolic volume(LVEDV), left ventricular endsystolic volume(LVESV), left ventricular enddiastolic pressure(LVEDP) and negatively correlated with left ventricular systolic pressure(LVSP), and left ventricular ejection fraction(LVEF). Conclusion Administration of intravenous adriamycin to rabbits results in DCM which in suitable for the conduction of research of neuroendocrine abnormality of heart. Overload of the left ventricle and increasing tension of left ventricular wall are key factors for regulating BNP excretion. Plasma BNP level is a good marker for evaluating degree of severity of cardiac function in DCM.

关 键 词：扩张型 心肌病 家兔 血浆 脑钠肽 射血分数 心功能 

分 类 号：R542.2[医药卫生—心血管疾病]