课件：心室重构与心力衰竭.pptVIP

* * * * * 见幻灯片 * * * Progression of hypertension and other early risk factors for heart failure. CHF = congestive heart failure; LVH = left ventricular hypertrophy; MI = myocardial infarction. From Arch Intern Med,20 with permission. * * * This figure depicts various stages in the growth of the myocardium and the myocardial response to chronic stress based primarily on the analysis of both Linzbach?and Hort. After an initial phase of simultaneous multiplication and enlargement of cardiomyocytes in the fetus and in the first few months of neonatal life, subsequent development of the adult heart occurs by enlargement of existing cardiomyocytes coupled with proliferation of the capillary network. The one-to-one ratio of cardiomyocytes to capillaries is maintained thereafter. In response to stress, the heart mass increases by hypertrophic enlargement of existing cardiomyocytes associated with polyploidy of nuclear DNA and formation of increased numbers of binucleated cardiomyocytes. (Because of orientation, binucleation is not seen in cross section.) Once a critical heart weight of 500 g (200 g left ventricular weight) is exceeded, this is followed by continued hypertrophy of existing myocytes plus the formation of new myocytes (hyperplasia), which Linzbach considered to occur by longitudinal splitting of myocytes. Further hypertrophy exceeds coronary vascular reserve with subsequent cardiomyocyte necrosis, rearrangement of cardiomyocytes, fibrosis, and structural dilatation of the chambers of the decompensated, failing heart. * * * * * * 心衰是各种心脏病的最终结局病情危重，市场需求巨大，由于芪苈强心理论创新、组方独特、显著改善心衰症状、抑制心室重构的独特优势，有广阔的市场前景，具备产业化基础。为此列入国家发改委高技术产业化项目，（支持1200万用于产业化），带动中药产业创新研究，从而推动中药制药行业现代化和产业化生产。芪苈强心也是863计划（2002AA2Z3223）、国家十一五科技支撑计划（2006BAI08B04-09）、2002年获国家发明专利、已获国家新药证书和生产批件、2006年国家高新技术产品。 * * * * * * * * 持续高水平的Ang II是促进胶原生成和成熟的重要机制，导致心肌纤维化和心脏左室重构的进行性发生。本研究选用雷米普利—一种ACEI药物，治疗稳定疤痕生成后 芪苈强心胶囊显著降低心肌梗死交界区MMP-2和MMP-9的活性，减少细胞外基质降解、减轻心脏支撑结构破坏和进行性心室扩张。* P0.05 vs Sham。 # * * 实验结束后（术后第8周）各组随