血管紧张素转换酶抑制剂的肝脏水平醛固酮逃逸现象及其干预作用研究  

Study on aldosterone escape of ACEI in liver and its interventional action

作　　者：崔素华[1] 张敏[1] 唐国华 丁伯平[3] 

机构地区：[1]安徽中医药高等专科学校,安徽芜湖241000 [2]芜湖市第一人民医院,安徽芜湖241000 [3]皖南医学院药理教研室,安徽芜湖241000

出　　处：《现代医药卫生》2012年第9期1292-1293,共2页Journal of Modern Medicine & Health

摘　　要：目的观察依那普利联合安体舒通(螺内酯)干预肝纤维化的作用是否伴有肝脏水平的"醛固酮逃逸"现象及醛固酮逃逸对肝脏纤维化的影响。方法应用40%四氯化碳(CCl4)灌胃建立大鼠肝纤维化模型,将60只雄性SD大鼠随机分为对照组(NC组)、模型组(Mo组)、依那普利组[En组,20 mg/(kg·d)]、依那普利联合安体舒通组[En+Sp组,20 mg/(kg·d)+20 mg/(kg·d)]。依那普利与安体舒通于造模同时连续灌胃给药,20周后处死大鼠。用放免法检测血浆、肝组织中血管紧张素Ⅱ(AngⅡ)、醛固酮水平。取肝组织,分别行苏木素伊红染色和马松三色染色,光镜下观察组织学改变。结果En组、En+Sp组肝匀浆中AngⅡ和醛固酮的含量、肝纤维化程度明显低于Mo组。结论依那普利在肝纤维化的防治中若长期使用同样存在肝脏水平的"醛固酮逃逸"现象,安体舒通与依那普利联用可以防止肝脏水平的"醛固酮逃逸",并加强对肝纤维化的防治作用。Objective To investigate whether the intervening liver fibrosis action of enalapril（EN） as angiotensin-convetting enzyme inhibitor （ACEI） combined spirolactone （SP） as aldosterone antagonist is accompanied by aldosterone （Aldo） escape and the influence of Aldo escape on hepatic fibrosis. Methods The rat model of hepatic fibrosis was established by gastric gavage of 40%CC14. Sixty male SD rats were randomly divided into the control group （NC）, model group （Mo）,enalapril group [En, 20 mg/（kg, d ）] and En＋Sp group[20 mg/（kg· d）＋20 mg/（kg· d）]. During the model construction, E N and Aldo were simultane- ously administrated by continuous gastric lavage. The rats were executed to death after 20 weeks. The radioimmunological method was adopted to detect the angiotensin Ⅱ （Ang Ⅱ ） and Aldo levels in plasma and liver tissue. The liver tissue was taken for HE and Masson staining and the histological changes were observed under light microscope. Results After 20-week treatment,the plasma Ang Ⅱ and Aldo concertrations and the degrees of live fibrosis in the En and En＋Sp groups were obviously lower than those in the Mo group. Conclusion During the prevention and treatment of hepatic fibrosis by long term use of En, Aldo escape may occur. Sp combined with En could prevent Aldo escape in liver and enhance the preventive and treatment role of hepatic fibrosis.

关 键 词：依那普利 肝硬化 血管紧张素转换酶抑制药 螺内酯 醛固酮逃逸 

分 类 号：R586.24[医药卫生—内分泌]