2006替米沙坦,安体舒通及其合用防治大鼠急性心肌梗死左室重构作用.docVIP

替米沙坦、安体舒通及其合用防治大鼠 急性心肌梗死左室重构的作用 陈国忠 傅国胜 赵志宏 于路 【摘要】　目的：评价选择性血管紧张素ⅡⅠ型受体拮抗剂替米沙坦和醛固酮受体拮抗剂安体舒通对大鼠急性心肌梗死（AMI）后左室重构的影响。方法：SD大鼠AMI模型建立24h后，随机分为AMI组、替米沙坦组、安体舒通组和两药合用组并以假手术组为对照。6周后，行血流动力学测定、形态学检测心脏重构过程。结果：各组平均心肌梗死面积差异无显著性（P＞0.05）。替米沙坦组和合用组显著降低左心室舒张末压（LVEDP）、左心室重量、室间隔厚度及左室截面内周长，安体舒通组仅仅减少了LVEDP。各组的非梗死区室间隔的非血管区胶原容积分数（CVF）均显著减少（P0.001）,合用组的CVF没有进一步减少。结论：替米沙坦干预能有效改善心室重构，与安体舒通合用没有叠加作用。但安体舒通可减少非梗死区心肌胶原的沉积，有一定的临床意义。 【关键词】 替米沙坦 安体舒通 心肌梗死 心室重构 【Abstract】　Objectives To compare the effects of telmisartan ,selective angiotensin Ⅱ type 1 receptor blocker (ARB) and spironolactone ,aldosterone blockade (AB) on the left ventricular (LV) remodeling after acute myocardial infarction (AMI) in the rats. Methods AMI was induced in male SD rats by ligating the left coronary artery. Twenty-four hours after the procedure, the 72 surviving rats were randomly divided into four groups (1) AMI controls ,(2) telmisartan,(3) spironolactone,(4) concomitant telmisartan and spironolactone groups; and (5) sham-operated group to serve as noninfarction controls. At 6 weeks after AMI, hemodynamic studies and pathologic analysis were performed in each group. Results There were no significant differences among the four AMI groups in MI size ( P0.05). left ventricular end diastolic pressures (LVEDP), LV weight, interventricular septal (IVS) thickness, LV cross-section in-perimeter (LVSPM) in the telmisartan and two drugs combining group were significantly reduced ( P0.05-0.001). while in spironolactone group,only LVEDP was reduced. collagen volume fractions(CVFs) in the non-infarcted zone (NIZ) were significantly reduced in the telmisartan, spironolactone and two drugs combination treatment group ( P0.001).Additionally,there was no significant difference in all indicators as stated above between telmisartan and two drugs combining group.Conclusions Telmisartan can effectively reduce LVEDP and prevent LV remodeling after AMI in rats . There are no additive effect in preventing LV remodel