氯沙坦、依那普利及其合用防治大鼠急性心肌梗死左室重塑作用的对比研究  

Losartan, enalapril and their combination on the prevention of left ventricular remodeling after AMI in rats

作　　者：杨跃进[1] 张沛[1] 阮英茆[2] 宋来凤[2] 徐新林[2] 李永利[3] 周燕文[3] 田毅[3] 陈纪林[1] 陈在嘉[1] 徐义枢[1] 

机构地区：[1]中国医学科学院中国协和医科大学阜外心血管病医院冠心病研究室,北京100037 [2]中国医学科学院中国协和医科大学阜外心血管病医院病理科,北京100037 [3]中国医学科学院中国协和医科大学阜外心血管病医院外科实验室,北京100037

出　　处：《中华心血管病杂志》2001年第6期361-364,共4页Chinese Journal of Cardiology

摘　　要：目的　对比氯沙坦、依那普利及其合用对大鼠急性心肌梗死 (AMI)左室重塑的防治作用。方法　雌性SD大鼠经冠状动脉结扎致AMI,术后 48h存活的 83只随机分成 :(1)AMI对照组 ,(2 )氯沙坦 (3mg·kg-1·d-1)组 ,(3)依那普利 (1mg·kg-1·d-1)组 ,(4 )氯沙坦和依那普利合用 (3mg·kg-1·d-1和 1mg·kg-1·d-1)组 ;另设 :(5 )假手术组和 (6 )正常组作对照。在给药治疗 4周后均行血流动力学测定、心脏标本固定和病理分析。最终 5 6只大鼠获完整资料 ,上述各组分别为 11、10、10、11、6和 8只大鼠。结果　 1～ 4组间MI面积 (4 1 7～ 43 4) %差异均无显著性 (P >0 0 5 )。与假手术组相比 ,AMI组左室舒张末期压 (LVEDP)、容积 (LVV)、长 (L)、短 (D)轴长度和左室实际重量 (LVAW)及相对重量 (LVRW)均显著增加 (P <0 0 5～ 0 0 0 1) ,发生了左室重塑 ;而左室内压最大上升和下降速率(±dp/dt)及其校正值均显著降低 (P均 <0 0 0 1)。与AMI对照组相比 ,氯沙坦、依那普利及其合用三个治疗组的LVEDP、LVV、LVAW和LVRW均显著降低或减小 (P <0 0 5～ 0 0 0 1) ;除氯沙坦组的 -dp/dt校正值外 ,±dp/dt校正值在三个治疗组均显著恢复 (P <0 0 5～ 0 0 0 1)。上述各指标在三个治疗组间差异均无显著性 (P均 >0 0 5 )。结?Objective To compare the effects of losartan, enalapril and their combination on the prevention of left ventricular remodeling (LVRM) after acute myocardial infarction (AMI) in rats. Methods AMI was produced in female SD rats by ligating the left coronary artery. Forty eight hours after the procedure, the 83 surviving rats were randomly divided into four groups:(1) AMI controls, (2) losartan(3 mg·kg -1 ·d -1 ), (3) enalapril (1 mg·kg -1 ·d -1 ),and (4) concomitant losartan and enalapril (3 mg·kg -1 ·d -1 and 1 mg·kg -1 ·d -1 ) groups; and (5) sham operated group and (6) normal group were selected randomly to serve as non infarction controls. Losartan and enalapril were delivered by direct gastric gavage. After 4 weeks of medical therapy, hemodynamic studies were performed in each group, and the rat hearts were then fixed with 10% formalin, and pathologic analysis was performed. Complete experimental data obtained in 56 rats were analyzed, comprising of ① AMI controls ( n =11), ② losartan group ( n =10), ③ enalapril group ( n =10), ④ concomitant losartan and enalapril group( n =11), ⑤ sham operated group ( n =6) and ⑥ normal controls ( n =8). Results There were no significant differences among the four AMI groups in MI size (41.7%-43.4%, all P >0.05). Compared with sham operated rats, the left ventricular (LV) end diastolic pressure (LVEDP), volume (LVV), long and short axis length (L and D), as well as LV absolute and relative weight (LVAW and LVRW) in the AMI group were all significantly increased ( P <0.05-0.001), indicating that LVRM occurred after AMI. The maximum left ventricular pressure rising and dropping rates (±dp/dt) and their corrected values were significantly reduced in the AMI group (all P <0.001). Compared with the AMI group, LVEDP, LVV, LVAW and LVRW were all significantly decreased in all three treatment groups ( P <0.05-0.001). The corrected ±dp/dt was significantly enhanced in all three treatment group

关 键 词：氯沙坦 依那普利 心肌梗塞 左室重塑 大鼠 治疗 对比研究 

分 类 号：R542.22[医药卫生—心血管疾病] R972[医药卫生—内科学]