冠脉微循环障碍参与慢性心力衰竭大鼠心肌重构  

Coronary microcirculation dysfunction participated in myocardial remodeling in rats with chronic heart failure

作　　者：孙桂芳[1] 刘凤岐[1] 修春红[1] 

机构地区：[1]哈尔滨医科大学第一临床医学院心内科,150001

出　　处：《中国地方病学杂志》2005年第5期500-502,共3页Chinese Jouranl of Endemiology

基　　金：黑龙江省"十五"科技攻关项目(GB01C126-03)

摘　　要：目的探讨冠脉微循环障碍在慢性心力衰竭(CHF)大鼠心肌重构中的地位与作用。方法Wistar大鼠随机分为实验组、对照组。实验组皮下注射异丙肾上腺素(340mg/kg),对照组皮下注射生理盐水0.5ml,连续2次,间隔24h。第2次注射结束3个月后测定血液动力学及左心室质量/体质量。左心室心肌行HE染色,Masson胶原染色,透射电镜检查,凝集素组织化学染色显现毛细血管。结果与对照组比较,实验组左心室收缩压、左心室压力上升和下降最大速率降低,左心室舒张末压、左心室质量/体质量升高。与对照组比较,实验组心内膜下心肌灶性坏死,胶原增加,电镜显示毛细血管痉挛。与对照组比较,实验组心内膜下心肌毛细血管密度[(1972±83)/mm2对(1633±62)/mm2]、心肌细胞密度[(1778±97)/mm2对(1588±87)/mm2]显著降低(P<0.001),毛细血管密度与心肌细胞密度的比值[(1.11±0.08)对(1.03±0.05)]显著降低(P<0.05)。结论冠脉微循环障碍参与CHF大鼠心肌重构,并且是造成CHF大鼠心肌重构的病因之一。Objective To study the status and function of coronary microcirculation dysfunction participated in myocardial remodeling in rats with chronic heart failure （CHF）. Methods Rats were randomized into experimental group and control group. Rats in experimental group were administered isoproterenol （340 mg/kg） subcutaneously two times 24 hours in between, while rats in control group were given 0.5 ml saline by the same way. Three months after the second injection, hemodynamic examination and the ratio of left ventricular weight to body weight were obtained. Haematoxylin and eosin staining, Masson staining for collagen, examination of transmission electron microscope and lectin staining for capillary were performed in left ventricular muscle. Results Compared with control group, left ventricular systolic pressure and the maximum of rise or fall in left ventricle pressure were decreased in experimental group, while left ventricular diastolic pressure and the ratio of left ventrieular weight to body weight were increased. Local necrosis, collagen deposition and capillary spasm confirmed by transmission electron microscope appeared in subendocardial myocardium of experimental group, which were quite different from those of control group. Capillary density and myocyte density were lower in subcndocardial myoeardium of experimental group than in those of control group [ （ 1 972 ± 83 ）/mm^2 vs （ 1 633± 62 ）/mm^2, （ 1 778 ± 97）/mm^2 vs （1 588 ± 87）/mm^2, P 〈 0.001 ], and the ratio of capillary density to myocyte density was lower too [ （ 1.11 ± 0.08） vs （ 1.03 ± 0.05 ）, P 〈 0.05 ]. Conclusion Microcirculation dysfunction participates in myoeardial remodeling in rats with CHF, which is the cause of myocardial remodeling in rats with CHF.

关 键 词：心力衰竭 心肌重构 微循环 痉挛 

分 类 号：R541.6[医药卫生—心血管疾病]