三类降压药物对高血压大鼠心肌细胞凋亡及左室重构的对比研究  

Contrast of losartan,fosinopril and amlodipine on cardiomyocyte apoptosis and left ventricular remolding in hypertensive rats

作　　者：余国龙[1] 梁晓秋[2] 郑剑卿[1] 谢秀梅[1] 

机构地区：[1]中南大学湘雅医院老年心内科,长沙410008 [2]衡阳医学院病理学部,衡阳421000

出　　处：《湖南医科大学学报》2001年第5期405-408,共4页Bulletin of Hunan Medical University

基　　金：湖南省科委资助(98ZN2008

摘　　要：目的 :评价氯沙坦、福辛普利、氨氯地平对自发性高血压大鼠 (SHR)心肌细胞凋亡及左室重构的效应。方法 :将 40只 16周龄SHR随机分为氯沙坦治疗组 (SHR -L)、福辛普利治疗组 (SHR -F)、氨氯地平治疗组 (SHR -A)及空白对照组 (SHR -C)。采用末端脱氧核糖核苷酸转移酶介导dUTP缺口末端标记、放免及病理检查方法对SHR治疗 8周、16周心肌细胞凋亡指数 (APOI)、血浆和组织血管紧张素II(PAngII,MAngII)及左室重构指标检测。结果 :①各治疗组治疗 8周、16周收缩压均明显下降 ,组间差异无显著性 ;各治疗组左室重量 (LVW)、左室重量指数 (LVMI)均有显著性改善 ,SHR -F组治疗 16周较其他两组LVMI显著减低。②仅SHR -F组治疗 8周APOI显著性下降 ,治疗 16周各治疗组APOI均有显著下降 ,尤以SHR -F组下降明显。③SHR -L组治疗 8周及 16周PAngII,MAngII显著增加。SHR -F组治疗 8周MAngII显著下降 ,治疗 16周SHR -F ,SHR -A两组MAngII均明显下降 ,且前组较后组下降显著 ,但对PAngII无明显影响。结论 :3药物均能有效逆转心脏肥厚及抗心肌细胞凋亡 ,其中以福辛普利显著。上述作用可能是拮抗心肌组织肾素 -血管紧张素 -醛固酮系统的效应。Objective To investigate effects of losartan, fosinopril and amlodipine on cardiomyocyte apoptosis, cardiac remolding in the spontaneously hypertensive rats (SHR). Methods SHRs were treated with lorsartan (SHR-L), fosinopril (SHR-F ), amlodipine (SHR-A),and untreated (SHR-C) respectively for 8 and 16 weeks. Cardiomyocyte apoptotic index (APOI),left ventricular mass,left ventricular mass index(LVM,LVMI),and plasma and myocardium angiotensin II(PAng II,MAng II) concentrations were examined. Results ① The systolic blood pressure was decreased similarly in all treatment groups in 8 and 16 weeks. LVMIs were reduced significantly in all treatment groups. LVMI was significantly lower in SHR-F group than that in other two treatment groups in 16 weeks.② APOIs were decreased significantly in SHR-F group in 8 weeks and in all treatment groups,especially in SHR-F group in 16 weeks.③ Compared with SHR-C group in both periods, PAng II and MAng II were significantly increased in SHR-L group,but MAng II concentration was only decreased significantly in SHR-F group in 8 weeks,and in SHR-F and SHR-A groups in 16 weeks. Conclusion Losartan,amlodipine,and especially fosinopril can inhibit cardiomyocyte apoptosis, prevent myocardial fibrosis,and reverse heart hypertrophy. Inhibition of myocardium rennin-angiotension-aldsteron system may be the mechanism of the three drugs' cardioprotective effects.

关 键 词：细胞凋亡 心肌肥厚 血管紧张素Ⅱ药物治疗 动物疾病模型 大鼠 高血压 氯沙坦 福辛普利 氨氯平 

分 类 号：R544.1[医药卫生—心血管疾病] R542.2[医药卫生—内科学]