螺内酯对继发性高血压大鼠肾脏的保护作用  

Renal Protection Role of Spironolactone in Hypertensive Rat

作　　者：何玲[1] 万国华[2] 李拥军[1] 田泽军[1] 

机构地区：[1]河北医科大学第二医院心内科,河北石家庄050000 [2]河北省人民医院老年病二科,河北石家庄050051

出　　处：《中华高血压杂志》2008年第1期46-50,共5页Chinese Journal of Hypertension

基　　金：河北省科技厅资助项目(No.002061124D;No.06276107D);河北省教委博士基金(B2004126);河北省卫生厅重点跟踪项目(0413)

摘　　要：目的观察螺内酯对高血压大鼠肾动脉重构的影响。方法在48只雄性Wistar大鼠中,随机选出36只,以腹主动脉缩窄法制备高血压模型,再随机分为3个亚组:高血压模型组(模型组,自来水灌胃+饮用1%盐水),高血压培哚普利组[培哚普利组,培哚普利2 mg/(kg·d)灌胃+饮用1%盐水],高血压螺内酯组[螺内酯组,螺内酯20 mg/(kg·d)灌胃+饮用1%盐水];其余12只进入假手术对照组(假手术组,只分离腹主动脉但不结扎,自来水灌胃+饮用自来水)。8周后超声检测肾动脉及肾内动脉收缩期和舒张期阻力指数(RI)和血流速度并比较各组的差异;12周后颈动脉插管法测量血压及病理学方法测定肾内动脉的血管重构指标。结果培哚普利和螺内酯均能降低高血压大鼠收缩压及舒张压(P<0.01),均使高血压大鼠的肾动脉RI、肾内动脉RI、血管内膜中膜厚度与管腔内腔的比值(M/L)及肾动脉内中膜纤维化程度明显下降(P<0.01～0.05),螺内酯上述作用比培哚普利更明显,螺内酯还能使高血压大鼠内中膜厚度显著降低(P<0.01);虽然培哚普利和螺内酯均能使高血压大鼠肾动脉及肾内动脉舒张末期血流速度及肾内动脉面积增加(P<0.01～0.05),螺内酯能更进一步降低肾动脉RI、M/L和内中膜纤维化比率(P<0.01～0.05)。结论培哚普利和螺内酯均能降低高血压大鼠血压,改善动脉重塑,在改善动脉重塑方面螺内酯效果比培哚普利更明显。Objective To observe the effects of spironolactone on vascular remodeling of renal arteries in hypertensive rats. Methods Hypertension model were established by abdominal aortic coarctation in male Wistar rats （n= 36） and then randomly to receive placebo （tap water＋ 1% NaCl）, or perindopril 2 mg/（kg · d）＋ 1% NaC1, or spironolactone 20 mg/（kg · d）＋1% NaC1; 12 rats were submitted as a sham operation. Drag indexes （RI） of renal arteries and intrarenal arteries, and the end diastolic velocity of renal arteries（VdRA）/interrenal arteries（VdInA）, the peak systolic velocity of renal arteries（VsRA）/intrarenal arteries （VsInA） were determined by ultrasonograph after 8 weeks. Blood pressure were measured in left carotic artery by catheterization and the remodeling of intrarenal artery were studied pathologically 12 weeks after. Results Perindopril and spironolactone both decreased SBP and DBP in hypertensive rats（P〈0. 01）, both decreased the RI of renal and intrarenal arteries, the ratio of middle layer thickness to luminal diameter （M/L） and the percentages of the fiberous area in the middle layer of renal arteries of hypertensive rats （P〈0. 01--0.05）, while the protection effects were more pronounced in spironolactone than that of perindopril. Although both perindopril and spironolactone increased VdRA and VdlnA, luminal area （LA）（P〈0. 01--0.05）, the effection RI of renal artery, M/L and percentages of the fiberous area in middle layer of renal arteries in were more obvious by spironolactone （P〈0. 01--0.05）. Conclusions Perindopril and spironolactone both decrease the blood pressure and improve vascular remodeling of renal arteries in renal hypertensive rats, whereas, the renal protective effect by spironolactone appeared to be superior to perindopril in the vascular remodeling.

关 键 词：肾脏 高血压 血管重构 螺内酯 培哚普利 

分 类 号：R544.1[医药卫生—心血管疾病]