加味人参四逆汤对急性心肌梗死后心力衰竭大鼠心功能的保护机制研究  

Protective Mechanisms of Modifided Renshen Sini Decoction for Heart Function in Rats with Heart Failure after Acute Myocardial Infarction

作　　者：李影雄[1] 蔡海荣 蔡惠铃 蔡鑫桂 李志雄 李怀国[1] 雷凯君[1] LI Ying-Xiong;CAI Hai-Rong;CAI Hui-Ling;CAI Xin-Gui;LI Zhi-Xiong;LI Huai-Guo;LEI Kai-Jun(Foshan Traditional Chinese Medicine Hospital,Foshan 528000 Guangdong,China;The Second Afliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510120 Guangdong,China)

机构地区：[1]佛山市中医院,广东佛山528000 [2]广州中医药大学第二附属医院,广东广州510120

出　　处：《广州中医药大学学报》2021年第6期1236-1241,共6页Journal of Guangzhou University of Traditional Chinese Medicine

摘　　要：【目的】探讨加味人参四逆汤对急性心肌梗死后心力衰竭大鼠心功能的保护作用。【方法】将雄性SD大鼠随机分为假手术组、模型组、培哚普利组、中药组。除假手术组,其他3组大鼠采用冠状动脉左前降支结扎方法建立急性心肌梗死后心力衰竭模型,假手术组完成穿刺但未结扎冠状动脉左前降支。成功造模后,培哚普利组、中药组大鼠分别对应给予培哚普利片混悬液、加味人参四逆汤灌胃,假手术组、模型组大鼠给予等体积生理盐水灌胃,共14 d。给药结束后,记录大鼠心脏频率(HR)、左心室内压最大上升速率(+dp/dtmax)、左心室内压最大下降速率(-dp/dtmax)、左心室内压(LVSP)、左心室舒张末期压(LVEDP)、左心室射血分数(LVEF)的变化;酶联免疫吸附分析检测血清中脑利钠肽(BNP)、肌钙蛋白T(cTnT)、血管紧张素Ⅰ(AngⅠ)、醛固酮(ALD)、心房钠尿肽(ANP)和心肌组织丙二醛(MDA)、超氧化物歧化酶(SOD)、肿瘤坏死因子α(TNF-α)、白细胞介素1(IL-1)水平;苏木素-伊红(HE)染色观察心肌组织变化和纤维化情况。【结果】与假手术组比较,模型组大鼠HR、+dp/dtmax、LVSP、LVEF和心肌组织SOD水平明显降低(P <0.05),-dp/dtmax、LVEDP,血清BNP、cTnT、AngⅠ、ALD、ANP水平和心肌组织MDA、TNF-α、IL-1水平明显升高(P <0.05),心肌结构排列紊乱,出现炎性浸润和心肌纤维化;与模型组比较,中药组大鼠HR、+dp/dtmax、LVSP、LVEF和心肌组织SOD水平明显升高(P <0.05),-dp/dtmax、LVEDP,血清BNP、cTnT、AngⅠ、ALD、ANP水平和心肌组织MDA、TNF-α、IL-1水平明显降低(P <0.05),心肌结构排列紊乱、炎性浸润和心肌纤维化明显减轻。【结论】加味人参四逆汤可以改善急性心肌梗死后心力衰竭大鼠的心功能,改善血流动力学,抑制神经体液因子分泌,减轻心肌氧化应激、炎性浸润和纤维化。Objective To explore the protective effects of modified Renshen Sini Decoction on heart function in rats with heart failure after acute myocardial infarction. Methods The male SD rats were randomly divided into sham-operation group,model group,perindopril group,and Chinese medicine group. Apart from the sham-operation group,the rats in the other 3 groups were induced into model of heart failure after acute myocardial infarction by ligation of left anterior descending coronary artery,and the sham-operation group only completed the puncture but had no ligation of the left anterior descending coronary artery. After successful modeling,the perindopril group and Chinese medicine group were given intragastric administration of perindopril suspension and modified Renshen Sini Decoction,respectively,and the sham-operation group and model group were given intragastric administration of the same volume of normal saline, the treatment lasting 14 days. After medication, the rat heart rate(HR),maximum rate of increase of left ventricular pressure(+dp/dtmax),maximum rate of decrease of left ventricular pressure(-dp/dtmax),left ventricular pressure(LVSP),left ventricular diastole after administration changes in end-stage pressure(LVEDP)and left ventricular ejection fraction(LVEF)were recorded, the levels of brain natriuretic peptide(BNP), troponin T(cTnT), angiotensin Ⅰ(Ang Ⅰ), aldosterone(ALD) and atrial natriuretic peptide(ANP)in serum,and malondialdehyde(MDA),superoxide dismutase(SOD),tumor necrosis factor α(TNF-α),interleukin 1(IL-1)in myocardial tissue were detected by enzyme-linked immunosorbent assay(ELISA),and the changes of myocardial tissue and fibrosis were observed by haematoxylin-eosin(HE)staining.Results Compared with the sham-operation group, the HR, + dp/dtmax, LVSP, LVEF and level of SOD in myocardial tissue in the model group were significantly reduced(P < 0.05),-dp/dtmax,LVEDP,serum levels of BNP, cTnT, Ang Ⅰ, ALD, ANP and the levels of MDA, TNF-α and IL-1 in myocardial tissue were significantly incr

关 键 词：加味人参四逆汤 急性心肌梗死 心力衰竭 心功能 血流动力学 神经体液因子 氧化应激 大鼠 

分 类 号：R285.5[医药卫生—中药学]