脓毒症时大鼠心脏的变化及血管紧张素转化酶抑制剂的保护作用  

The protective effects of angiotensin-converting enzyme inhibitor （ACEI） on the heart in sepsis rats

作　　者：王国兴[1] 沈潞华[1] 谢苗荣[1] 金明[1] 龙维[1] 

机构地区：[1]首都医科大学附属北京友谊医院急诊科,北京100050

出　　处：《中华急诊医学杂志》2007年第2期138-142,共5页Chinese Journal of Emergency Medicine

基　　金：首都医学科研发展基金（2002-1007）

摘　　要：目的研究脓毒症大鼠心脏功能、心肌力学的改变及血浆血管紧张素Ⅱ浓度变化，并探讨血管紧张素转化酶抑制剂（ACEI）对心脏的保护作用。方法Wistar大鼠随机分为对照组（32只）、脂多糖（US）组（32只，予LPS4mg／Kg静脉注射）及US＋ACEI组（32只，予雅施达2mg/Kg连续灌胃3d，第4天静脉注射US）。各组动物均经右颈总动脉左心室内插管，监测左室功能变化．并于实验前（0点）及给药后2、4、6h采血（每时间点8只）行血管紧张素Ⅱ、肌钙蛋白T（TNT）检测。结果①脓毒症状态下TNT显著升高，应用ACEI后明显降低[（1．30±0．53）μg／L vs （0．40±0．34）μg／L，P〈0．01）]。②脓毒症状态下，血管紧张素Ⅱ浓度升高，且可被ACEI制剂雅施达抑制[（1223．27±483．72）ng／L vs （383．0±182．22）ng／L，P〈0．01）]。③脓毒症状态下左心室收缩峰压（LVPP）、左心室压力上升（下降）最大速率（±dp/dt）均有不同程度变化，左心室舒张末期压（LVEDP）升高，应用ACEI可明显降低。结论①脓毒症可致大鼠心肌发生明显损伤，该损伤的发生可能和AngⅡ有关；②ACEI可明显改善脓毒症时的心肌损伤。concentrations of Objective To observe the changes of cardial function, myocardial mechanics and Angiotensin Ⅱ in sepsis rat model, and to investigate mechanism of the protective effect of rting enzyme inhibitor （ACEI） on heart. Method Wistar rats were randomly divided into control group, LPS group （4 mg/kg LPS i. v. ）, LPS ＋ ACEI group （2 mg/kg Acertil i. g. for the first three days, LPS i. v. on the 4 th day） ; thirty-two rats were in every each group. Rats were catheterized through right common carotid artery to left cardiac ventricle. Function of the left ventricle was monitored and blood was drawn at 0, 2 hours, 4 hours, 6 hours to detect concentrations ofAngiotensin H , TNT, eight rats at each time. Re, tits （D In sepsis rats, TNT increased significantly and this change could be inhibited by ACEI [ （1.30 ± 0.53） pg/L vs （0.40 ± 0.34） pg/L, P 〈 0.01 ]（2） In sepsis rats, Angiotensin Ⅱ increased significantly and this change could be inhibited by ACEI [ （1223.27±483.72） ng/Lvs （383.0± 182.22） ng/L, P 〈0.01]. （3） LVPP and ＋ dp /dt changed in various magnitude and left ventricular end-diastolic pressure （LVEDP） increased, hut these changes could be negatively impacted when ACEI was used. Conclusions （1） Myocardium was obviously damaged in rats with sepsis and it was associated with Angiotensin Ⅱ . （2） ACEI could improve cardiac damage caused by sepsis.

关 键 词：脓毒症 脂多糖 血管紧张素Ⅱ 血管紧张素转化酶抑制剂 

分 类 号：R686[医药卫生—骨科学]