螺内酯对扩张型心肌病大鼠心肌重塑的影响  

Effect of spironolactone on cardiac remodeling in rats with dilated cardiomyopathy

作　　者：白洁[1] 张国辉[2] 陈蓉[2] 盛佳[2] 汪建飞[2] 

机构地区：[1]第二军区大学附属长海医院老年病科,上海市200433 [2]江苏大学附属第一人民医院心内科,江苏省镇江市212002

出　　处：《实用老年医学》2011年第1期68-70,F0002,共4页Practical Geriatrics

摘　　要：目的观察螺内酯对扩张型心肌病(DCM)大鼠心肌重塑的影响。方法取正常大鼠10只作为对照组,DCM大鼠模型40只,随机分为4组∶DCM对照组、螺内酯干预低剂量组、中剂量组、高剂量组,灌胃量分别为生理盐水10 ml/(kg.d),螺内酯10、20、40 mg/(kg.d),并于给药8周后处死取心肌观察胶原含量,测定胶原容积百分比,取血清检测Ⅲ型前胶原氨端肽(PⅢNP)。多组均数比较用q检验及方差分析。结果心肌胶原容积百分比比较:螺内酯干预中剂量组(12.13±0.45)%、高剂量组(11.30±1.10)%与DCM对照组(24.33±0.92)%比较减少(P<0.05)。血清PⅢNP水平比较:螺内酯干预中剂量组[(131.95±9.20)ng/ml]、高剂量组[(226.08±22.10)ng/ml]与DCM对照组[(234.17±26.60)ng/ml]比较下降(P<0.05)。结论予以DCM大鼠螺内酯20 mg/(kg.d)或40 mg/(kg.d)治疗8周可改善胶原沉积,一定程度上逆转心肌重塑。Objective To study the effect of aldosterone receptor antagonists（spironolactone） on cadiac remodeling in rats with dilated cardiomyopathy. Methods Ten normal rats were selected as control group. Meanwhile, forty adriamycininduced dilated cardiomyopathy （DCM） rats were randomly divided into 4 groups： DCM control group, low-dose group, middle-dose group and high-dose group. Ttle normal control group received physiological saline 10 mg/（kg·d）, and three spironolactone groups received spironolactone 10, 20, 40 mg/（ kg·d） respectively. Histopathological characteristics were observed, and then collagen volume fractions were calculated. N-terminal popeptide of collagen type m （PmNP） was measured at the 9th week. Results The collagen percents （ % ） in the middle-dose group （ 12. 13 ± 0. 45 ） % and the high dose group （ 11.30 ± 1.10） % were more significantly reduced than that in the DCM group （ 24. 33± 0. 92 ） % （ P 〈 0. 05 ）. The standards of PmNP in serum （ng/ml） in the middle-dose group （131.95 ±9. 20 ng/ml） and the high-dose group （226. 08±22. 10 ng/ml） were more significantly reduced than that in the DCM group （234. 17 ± 26. 60 ng/ml ,P 〈 0. 05 ）. Conclusions The treatment of 20 rag/（ kg. d） or 40 mg/（ kg·d） spironolactone for 8 weeks can reduce the collagen percent and fibrosis degree of cardiac muscle, and can improve the cardiac compliance. They partly block the renal-angiotention-aldosterone system and balance the disfunction neuroendocrine system when dilated cardiomyopathy happens.

关 键 词：螺内酯 扩张型心肌病 心肌重塑 

分 类 号：R332[医药卫生—人体生理学] R542.2[医药卫生—基础医学]