益气活血利水方对心肌梗死后心衰大鼠N-末端脑钠肽前体水平及超微结构影响随机平行对照研究  

The Influence Of YiQiHuoXueLiShui Preseription On Amino Termnal Pro Brain Natriuretic Peptide And Uitrastructure Of Heart Cells In Rats With Congestive Heart Failure After Myocardial Infarction Random Parallel Control Study

作　　者：闫虹[1] 张艳[2] 

机构地区：[1]沈阳市儿童医院内科,沈阳110032 [2]辽宁中医药大学附属医院心肺康复科,沈阳110847

出　　处：《实用中医内科杂志》2017年第5期48-51,共4页Journal of Practical Traditional Chinese Internal Medicine

摘　　要：[目的]观察益气活血利水方对心衰大鼠N-末端脑钠肽前体水平及心肌细胞超微结构影响。[方法]使用随机平行对照方法,将75只SPF级SD大鼠编号按随机数字表方法分为5组,假手术组、模型组、益气活血利水方(高、中、低剂量)组,15只/组。采用结扎大鼠左冠状动脉配合力竭式游泳建立心肌梗死后心衰大鼠模型,实验第1d,各组大鼠麻醉后露腹背位固定,经喉气管插管连接小动物呼吸机辅助呼吸;在胸部左侧第3、4肋间隙行一切口,将左冠状动脉主干支结扎;观察心电图,显示ST段显著抬高;假手术组大鼠不行左冠状动脉主干支结扎手术,仅穿线;回置心脏于胸腔、缝合,腹腔注射青霉素20万U,1次/d,连续3d;实验第1d(造模1d),常规喂养1周,第2周饲料减1/2量,每天游泳至疲乏无力(游泳力竭时间随状态变差,从初始3h减少为30min),1次/d,连续4周。灌胃干预,模型组及假手术组3m L生理盐水,益气活血利水方组(高、中、低剂量)灌注3m L不同浓度药汁,1次/d;连续灌胃干预6周后,戊巴比妥钠(40mg/kg)腹腔麻醉,腹主动脉取血,静置30min,3000r/min速度离心15min,分离后取上清液;电镜观察心肌细胞超微结构,电化学发光法测量N-末端脑钠肽前体。[结果]心肌细胞超微结构假手术组排列整齐,结构完整、清晰;模型组大鼠具有溶解倾向,肌丝松弛、断裂,结构损伤、破坏;益气活血利水方高剂量组排列整齐,结构未破坏;中剂量组结构松散,排列较整齐;低剂量组肌丝松弛,细胞排列较整齐。N-末端脑钠肽前体水平各组均高于假手术组(P<0.01);益气活血利水方高、中、低剂量组均低于模型组(P<0.01);益气活血利水方低、中、高剂量组呈递减趋势,组间均差异显著(P<0.01)。[结论]益气活血利水方可降低心肌梗死后心衰大鼠N-末端脑钠肽前体水平,改善心肌细胞超微结构,呈量效关系,高剂量组作用更明显。[Objective] To observe the effects of Yiqi Huoxue Lishui prescription on serum amino terminal pro-brain natriuretic peptide（NT-proBNP） level and uitrastrueture of heart cells in heart failure rats. [Methods] Using random parallel control method, 75 cases of rats were randomly divided into five groups according to roll the dice method： sham group, model group, high and medium and low-dosage of yiqihuoxuelishui groups. Rat models with post-myocardial infarction heart failure were established by left auterior descending coronary arteryligation. Rats in model group and sham group were given 3ml saline. The high, middle and low dose groups of Yiqi Huoxue Lishui groups were given with different concentrations of 3ml, 1/d. After 6 weeks, the levels of NT-proBNP and myocardial uhrastructure in rats were compared. [Results] The uhrastructure of myocardial cells in sham group was arranged in neat,complete and clear. The ultrastruncture of myocardial cells in model group had the tendency of dissolution, the relaxation and breakage of muscle fibers, the damageand destruction of the structure. The high dose group of Yiqi Huoxue Lishui decoction was arranged in order and the structure was not damaged. The middle dose group had loose structure and orderly arrangement. In the low dose group, the muscle fibers were relaxed and the ceils were arranged orderly. The NT-proBNP level of the others group was higher than the sham group. The high, middle and low dose groups were lower than the model group （P〈0.01）. The low, middle and high dose groups showed the trend of decreasing and the difference was significant （P〈0.O1）. [Conclusion] Yiqihuoxnelishui prescription could decrease the NT- proBNP level and improve the myocardial cell ultrastructure concentrations in serum and high dose group could be more apparent.

关 键 词：心肌梗死后心衰大鼠 益气活血利水方 结扎左冠状动脉 力竭式游泳 灌胃干预 N-末端脑钠肽前体(NT-pro BNP) 心肌细胞超微结构 量效关系 实验研究 随机平行对照研究 

分 类 号：R541.6[医药卫生—心血管疾病]