安体舒通、培哚普利及其合用对大鼠心肌梗死后心室重构和心肌间质胶原的影响  

作　　者：张晓宏 

机构地区：辽宁省北票市第一人民医院,122100

出　　处：《中外健康文摘：医药月刊》2008年第8期875-877,共3页

摘　　要：目的观察醛固酮受体拮抗剂-安体舒通、血管紧张素转换酶抑制剂-培哚普利对大鼠急性心肌梗死（AMI）后左心室重构和胶原增生的影响,探索醛固酮受体拮抗剂和血管紧张素转换酶抑制剂降低AMI后病死率的机制。方法结扎大鼠左前降支建立急性心肌梗死模型,将48只雌性Sprague-Dawley（SD）AMI大鼠随机分为：AMI对照组（n=11）、安体舒通组（n=10,20mg/kg/d）、培哚普利组（n=10,10mg/kg/d）及其联合用药组（n=9,安体舒通20mg/kg/d＋培哚普利10mg/kg/d）,另设假手术组（n=8）。术后4周进行血流动力学测定、病理分析和非梗死区I、III型胶原含量的测定。结果AMI对照组与假手术组相比,左心室舒张末压（LVEDP）、容积、重量和非梗死区I、III型胶原含量均显著增加;左心室球形指数、左心室内压最大上升和下降速率（±dp/dt/LVSP）均显著降低。安体舒通组与AMI对照组相比,以上各指标多数无显著差异,仅左心室非梗死区I、III型胶原含量显著减少。培哚普利组和联合用药组与AMI组相比,LVEDP、左心室实际重量显著降低;左心室容积仅联合用药组有显著降低;而两组的＋dp/dt/LVSP显著增加;联合用药组的-dp/dt/LVSP显著增加。安体舒通、培哚普利和联合用药3组与AMI组相比,左心室非梗死区I型和III型胶原含量显著减少;且3组之间对胶原沉积的防治作用无显著性差异。结论单纯应用安体舒通能有效抑制AMI左心室非梗死区I、III型胶原的增生,提示安体舒通可能有改善左心室重构的潜在作用。培哚普利与安体舒通两药合用可更有效防治AMI后左心室重构,改善左心室舒张功能,其降低AMI后病死率和防治左心室重构的原因之一与减轻胶原沉积有关。Omaxirnal rate of rise and fall （ ± dp/dt） and their adjustment by LVSP （ ± dp/dt/LVSP） were significantly decreased, CVF of type I and type III in the infracted zone and noninfracted zone of LV were all significantly increased in the A/Ⅵ control group.There was no significant difference between spirolactone group and A/Ⅶgroup beside type Ⅰ and ⅢCVF in the noninfracted zone of LV.Compared with AMI group, LVEDP, LV weight were significandy decreased in perdopriol group and combination group, and ＋dp/dt/LVSP were increased in both groups.While -dp/dt/LVSP increased in only combination group.There was no significant difference between spirolactone group, perdopriol group and the combination group in decreasing collagen deposition in the noninfracted zone. Conclusion： Spirolactone can effectively decrease collagen deposition in the noninfracted zone, and the combination ofperdopfiol and spirolactone can improve left ventricular remodeling and LV dilatation.

关 键 词：心肌梗死 左心室重构 胶原 安体舒通 培哚普利 

分 类 号：R917[医药卫生—药物分析学;医药卫生—药学]