缬沙坦和卡托普利对缺血再灌注纤溶活性、内皮血管活性物质的影响  

The effects of valsartan and captopril on fibrinolytic activity and vasoactive mediators in ischemic reperfusion.

作　　者：刘恒亮[1] 赵继良[2] 刘灵芝[1] 康运凯[1] 张文莲[1] 

机构地区：[1]郑州市第五人民医院心内科,河南郑州450002 [2]河南省沈丘县中医院,河南沈丘46630

出　　处：《中国心血管杂志》2004年第1期8-11,共4页Chinese Journal of Cardiovascular Medicine

基　　金：郑州市自然科学基金资助项目 ( NO:2 0 0 2 8-6-4 )

摘　　要：目的　探讨缬沙坦和卡托普利对缺血再灌注纤溶活性、内皮血管活性物质的影响。方法　新西兰大白兔 6 0只 ,随机分为五组 ,每组 12只 , 组 :假手术组 , 组 :急性心肌梗死 (AMI)组 , 组 :缺血再灌注 (ischem ic reperfu-sion,IR)组 , 组 :IR+卡托普利组 , 组 :IR+缬沙坦组 ;各组 (除 组外 )分别结扎冠状动脉左心室支中点 ,缺血6 0 min,松开结扎线再灌注 2 4 0 min后 ( 组不进行再灌注 ) ,分别取结扎前、再灌注前、再灌注 2 4 0 min血测定内皮素 (endochelin ,ET)、一氧化氮 (nitric oxide NO)浓度和组织型纤溶酶原激活剂 (tissue- type plasminogen activa-tor,t- PA )、纤溶酶原激活剂抑制物 (,plasm inogen activator inhibitor PAI)活性。结果　冠状动脉结扎后 ,血浆ET、NO浓度和 PAI活性显著升高 (P<0 .0 1) ,t- PA活性显著下降 (P<0 .0 1) ,再灌注后 ,血浆 ET、NO浓度和 PAI活性进一步升高 ,t- PA活性进一步下降 ,与再灌注前对比均有显著性差异 (P<0 .0 1)。再灌注后 ,与 IR组对比 ,卡托普利、缬沙坦均能显著的升高 t- PA活性 ,降低血 PAI活性和 ET、NO浓度 (P<0 .0 1)。结论　卡托普利、缬沙坦有改善缺血再灌注过程中纤溶活性、抑制内皮细胞释放 ET。Objective To explore the significance of fibrinolytic activity and of vasoactive mediators in ischemic reperfusion in rabbits, and the effect of intervention of valsartan and captopril.Methods Sixty New Zealand white rabbits were randomly assigned to five groups, twelve for each. Group Ⅰ: Sham group; Group Ⅱ: Acute myocardial infarction(AMI) group; Group Ⅲ: ischemic reperfusion(IR)group; Group Ⅳ: IR+Captopril group; Group Ⅴ: IR+valsartan group. The middle point of left ventricular coronary artery was ligated for 60 minutes(except group I). After that, reperfusion for 240 minutes(except groupⅡ ). Before ligation, before and 240 minnutes after reperfusion , Blood was collected for measuring the plasma concentration of endothelin (ET) , nitric oxide (NO) and the plasma activity of tissue-type plasminogen activator(t-PA), plasminogen activator inhibitor( PAI) respectively. Results After ligation, The plasma concentration of ET,NO and the plasma activity of PAI were significantly higher than those before ligation(P<0.01), but the plasma activity of t-Pa were remarkably decreased than those before ligation(P<0.01). After reperfusion, Plasma concentration of ET, NO and plasma activity of PAI were significantly higher than those before reperfusion(P<0.01),conversely, the plasma activity of t-Pa were remarkably decreased than those before reperfusion(P<0.01). After reperfusion, The plasma concentration of NO, ET and plasma activity of PAI in captopril and valsartan group were significantly decrease than those in IR group (P<0.01).Conversely, the plasmaactivity of t-Pa in captopril and valsartan group were remarkably increase than those in IR group(P<0.01). Conclusion Captopril, valsartan can improve fibrinolytic activity, decrease release of ET, NO in ischemic reperfusion in rabbits.

关 键 词：缺血再灌注 卡托普利 缬沙坦 纤溶活性 内皮素 一氧化氮 

分 类 号：R542.22[医药卫生—心血管疾病]