AT_1受体阻断剂络萨坦对大鼠急性心肌梗死左室重构的防治作用  

Preventive effects of AT_1 receptor blocker Losartan on left ventricular remodeling after acute myocardial infarction in rat

作　　者：张沛[1] 杨跃进[1] 阮英茆[1] 宋来凤[1] 徐新林[1] 李永利[1] 周燕文[1] 田毅[1] 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心血管病研究所阜外心血管病医院,北京100037

出　　处：《中国急救医学》2001年第7期373-375,共3页Chinese Journal of Critical Care Medicine

基　　金：国家教委回国启动基金资助课题

摘　　要：目的　评价络萨坦对大鼠急性心肌梗死 (AMI)左室重构的防治作用。方法　AMI雌性SD大鼠 41只随机分成AMI组 (n =19)和络萨坦〔3mg/ (kg·d)〕组 (n =2 2 ) ,另设正常组 (n =10 )和假手术组 (n =10 )作对照。络萨坦以直接灌胃给予 ,4周后各组均行血流动力学测定、心脏标本固定和病理分析。去除梗死面积 <35 %或 >45 %的大鼠 ,最终分组为AMI组 (n =11)、络萨坦组 (n =10 )、假手术组 (n =6 )和正常组 (n =8) 4组。结果　各指标在假手术与正常组间均无显著差异 (P均 >0 0 5 ) ;梗死面积在AMI和络萨坦组间也无显著差异 (4 3 4%对 42 9% ,P >0 0 5 )。与假手术组相比 ,AMI组左室 (LV)舒张末压(LVEDP)、容积 (LVV)及实际 (LVAW)和相对重量 (LVRW)均显著增加 (P <0 0 1～ 0 0 0 1) ;而左室内压最大上升和下降速率 (±dp/dt)及其LV收缩压 (LVSP)的校正值 (±dp/dt/LVSP)均显著降低 (P <0 0 5～ 0 0 0 1)。与AMI组相比 ,络萨坦组的LVEDP显著降低〔10 5mmHg对 18 7mmHg ,(1mmHg =0 133kPa) ,P <0 0 1〕 ,LVV显著减小 (0 6 2ml对 0 75ml,P <0 0 5 ) ,LVAW和LVRW均显著减轻 (LVAW :6 13 5mg对 6 79 9mg ;LVRW :1 97mg/g对 2 5 2mg/g,P均 <0 0 5 ) ;而 +dp/dt/LVSP也显著增加(4 4 8对 38 8,P <0 0 1)?Objective To assess the effect of Losartan in preventing left ventricular remodeling (LVRM) after acute myocardial infarction (AMI) in the rat.Methods Forty-one surviving AMI female SD rats were randomized to AMI controls (n=19) or Losartan [3 mg/(kg·d)]group(n=22).Meanwhile,sham-operated(n=10) and normal rats (n=10) were randomly selected to serve as non-infarction controls.Losartan was delivered by direct gastric gavage.Four weeks after the therapy,hemodynamic measurement was performed in each group.Subsequently,the rat hearts were fixed and pathological analysis was performed on them.Exxclusive of the rats with MI sizes<35% or>45%,complete experimental data were obtained in 35 rats,which were comprised of AMI (n=11),Losartan (n=10), sham-operated (n=6) and normal groups (n=8).Results There were on significant differences in all indices between sham-operated and normal rats (all P >0 05).There was also no significant difference in MI size between AMI and Losartan groups (43.4% vs 42.9%, P >0.05).Compared with sham-operated rats,the left ventricular (LV) end diastolic pressure (LVEDP),volume (LVV),absolute and relative weight (LVAW and LVRW) in AMI controls were all significantly increased ( P <0.01～0.001);and the maximum LV pressure rising and dropping rates (±dp/dt) and their corrected values by LV systolic pressure (±dp/dt/LVSP) in AMI group were also significantly reduced ( P <0.05～0.001).Compared with AMI controls,LVEDP,LVV,LVAW and LVRW in Losartan group were all significantly reduced (LVEDP:10.5 mmHg vs 18.7 mmHg, P <0.01;LVV:0.62 ml vs 0.75 ml, P <0.05;LVAW:613.5 mg vs 679.9 mg, P <0.05;LVRW:1.97 mg/g vs 2.52 mg/g, P <0.05),and+dp/dt/LVSP was also significantly increased (44.8 vs 38.8, P <0.01).Conclusion Losartan can effectively prevent from LV remodeling and improve LV systolic function after AMI in the rat.

关 键 词：心肌梗死 左室重构 络萨坦 大鼠 AT1受体阻断剂 

分 类 号：R542.22[医药卫生—心血管疾病] R541.9[医药卫生—内科学]