依那普利氯沙坦及两者合用对心肌梗死后大鼠左室重塑干预的对比研究  

Effects of enalapril, losartan, and combination intervention on left ventricular remodeling after AMI in rats

作　　者：卜聪亚[1,2] 陈运贞[1] 

机构地区：[1]重庆医科大学第一附属医院心内科 [2]北京安贞医院12病区北京,100029

出　　处：《临床心血管病杂志》2003年第10期612-614,共3页Journal of Clinical Cardiology

摘　　要：目的 :对比依那普利、氯沙坦及两者合用对急性心肌梗死 (AMI)后大鼠左室重塑 (LVRM)的防治作用。方法 :AMI术后 2 4h存活的 4 3只雄性Wistar大鼠随机分为 :①AMI对照组 ,②依那普利 (10mg·kg- 1 ·d- 1 )组 ,③氯沙坦 (2 0mg·kg- 1 ·d- 1 )组 ,④依那普利 (5mg·kg- 1 ·d- 1 )与氯沙坦 (10mg·kg- 1 ·d- 1 )合用组 ;另设假手术组及正常对照组。各治疗组于术后第 2日起灌胃给药 ,连续 4周。行心脏标本病理分析 ,放免法测血浆和左室非梗死区 (LVNIZ)血管紧张素Ⅱ (AngⅡ )含量 ,氯氨T法测LVNIZ羟脯氨酸含量 (HC)。结果 :AMI后心脏重量 (HW)、心脏重量指数 (HWI)、左室重量 (LVW )、左室重量指数 (LVWI)、LVNIZAngⅡ、HC均显著增加 (P <0 .0 5～ 0 .0 1) ;与AMI对照组相比 ,各治疗组上述参数均降低 (P <0 .0 5～ 0 .0 1) ,其中合用药组降低HWI、LVWI最为显著 (均P <0 .0 1) ,而依那普利组HC降低最为明显 (P <0 .0 1)。AMI后血浆AngⅡ明显升高 ,与AMI对照组相比 ,依那普利及合用药组均使其显著降低 ,而氯沙坦组使其更加升高。结论 :依那普利、氯沙坦及两者合用均能有效改善大鼠心肌梗死后LVRM ,合用药对降低HWI、LVWI有叠加效应。Objective:To compare the effects of enalapril, losartan and combination on left ventricular remodeling (LVRM). Methods:Forty three Surviving AMI male Wistar rats were randomly divided into 4 groups at 24 h after MI: (1) AMI controls, (2) enalapril (10 mg·kg -1 ·d -1 ), (3) losartan (20 mg·kg -1 ·d -1 ), (4) enalapril and losartan in combination(5 mg·kg -1 ·d -1 and 10mg·kg -1 ·d -1 ) groups. Sham operated and normal rats were randomly selected as non infarcted controls. Drugs were delivered by direct gastric gavage for 4 weeks beginning at the 2nd day after AMI. LVRM was evaluated by pathologic analysis, the levels of AgⅡ in plasms and in LVNIZ were measured by radioimmunoassay. Hydroproline concentration (HC) in LVNIZ were measured by chloramine T method. Results:AMI significantly increased in heart weight (HW), heart weight index (HWI), left ventricular weight (LVW), left ventricular weight index (LVWI), the levels of AngⅡ in LVNIZ and HC as well (P< 0.05 ～ 0.001 ). Compared with MI group, parameters mentioned were all significantly decreased in three treatment groups (P< 0.05 ～ 0.001 ), however, HWI, LVWI were decreased most remarkably in combination group (P< 0.01 ～ 0.001 ) while HC in enalapril group (P< 0.001 ). Plasma AngⅡ were remarkably elevated after MI, which were greatly depressed in enalapril and combination drug group but increased in losartan group. Conclusion:Both enalapril and losartan can attenuate LVRM after MI in rats. There are additive effect in decreasing HWI, LVWI when the two drugs were used in combination.

关 键 词：心肌梗死 依那普利 氯沙坦 左室重塑 

分 类 号：R542.2[医药卫生—心血管疾病]