坎地沙坦对兔左室射血分数保留心力衰竭模型心室重构及心功能的影响  

The effect of candesartan on ventricular remodeling and cardiac function in heart failure with preserved ejection fraction rabbit model

作　　者：张华丽[1,2] 王蕾[1] 张世杰[3] 李莉[1] 

机构地区：[1]郑州大学第一附属医院急诊医学部,郑州450052 [2]河南省高等学校临床医学重点学科开放实验室 [3]郑州大学第一附属医院检验科

出　　处：《临床急诊杂志》2016年第1期48-52,共5页Journal of Clinical Emergency

基　　金：国家临床重点专科建设项目(No:2012649)

摘　　要：目的:探讨坎地沙坦对左室射血分数保留的心力衰竭(HFpEF)心室重构及心功能的影响。方法:将24只新西兰白兔随机分成对照组、HFpEF组和给药组,每组各8只,HFpEF组给予缩窄腹主动脉,给药组在缩窄腹主动脉后给予坎地沙坦酯片1mg/(kg·d)灌胃,经心脏彩超及血流动力学测定对比其心功能的不同,经常规病理染色比较各组心肌标本的病理及间质重构的差异。结果:术后90d,HFpEF组较对照组室壁显著增厚,左房内径(LAD)明显扩大,二尖瓣舒张早期血流峰值与舒张晚期血流峰值之比(E/A)显著升高、等容舒张时间(IVRT)明显增加(P<0.01),而射血分数(EF)正常;左室舒张末压(LVEDP)明显升高,左室松弛时间常数(tau)也显著延长(P<0.01);心肌间质增生及重构明显(P<0.01)。而给药组的室壁厚度、间质增生及重构程度都较HFpEF组轻,但较对照组重(P<0.05,P<0.01)。结论:坎地沙坦能显著改善压力负荷诱导的心室重构及心功能的改变,从而延缓整个病理过程发展到HFpEF。Objective：Disscussing the candesartan＇s effects on cardiac remodeling and function in heart failure with preserved ejection fraction（HFpEF）rabbit model.Method：Twenty-four New Zealand white rabbits were divided into three groups：control group（n=8）,HFpEF group（n=8）,and candesartan group（n=8）.The HFpEF group were built by constricing abdomial aorta,and the candesartan group was treated with 1 mg/（kg·d）after constricing abdomial aorta 24 hours.The cardiac function and pathological stutas were measured with echocardiography,hemodynamic assays and pathological stain.Result：About ninety days after surgery,there were significantly increased ventricular wall thickness,enlarged left atrium,increased E/A and LVEDP,prolonged IVRT and tau（P〈0.01）,but normal left ventricular ejection fraction（LVEF）,and significantly increased interstitial remodeling in the HFpEF group compared with control group（P〈0.01）.And ventricular wall thickness and interstitial remodeling stutas in candesartan group were lower than those in the HFpEF group（P〈0.01）,but a little higher than those in the control group（P〈0.05,P〈0.01）.Conclusion：Candesartan could significantly improve the changes of ventricular remodeling and cardiac function induced by pressure overload,thus it can postpone the whole pathological progression develop to HFpEF.

关 键 词：射血分数保留的心力衰竭 坎地沙坦 心室重构 心功能 

分 类 号：R541.6[医药卫生—心血管疾病]