卡维地洛、西拉普利及其合用防治大鼠急性心肌梗死左室重塑的作用

目的:评价卡维地洛、西拉普利及其合用防治大鼠急性心肌梗死(AMI)左室重塑(LVRM)的作用。方法:AMI术后24h存活的100只雌性SD大鼠随机分成:①AMI对照(n=25)、②AMI+卡维地洛(1mg·kg^-1·d^-1, n=25)、③AMI+西拉普利(1mg·kg^-1·d^-1, n=25)及④AMI+合用(n=25)4组;另设假手术组(n=17).直接灌胃给药。4周后行血流动力学测定和病理学分析。去除梗死面积<35%或>55%者, 最终在以上各组分别有(13, 12, 12, 14)和13只大鼠。结果:AMI各组间梗死面积差异均无显著性(45.2%-46.7%, 均P>0.05).AMI对照组的左室舒张末压(LVEDP)、容积(LVV)、重量(LVW)和室间隔厚度(STh)均显著大于假手术组(均P<0.01), 左室内压最大上升和下降速率(±dp/dt)及其校正值(±dp/dt/LVSP)均显著低于假手术组(P<0.05, P<0.01).卡维地洛、西拉普利及合用组的LVEDP、LVV均显著低于AMI对照组(P<0.01), STh均显著薄于AMI对照组(P<0.01), LVW均显著轻于AMI对照组(P<0.05, P<0.01), ±dp/dt显著高于AMI对照组(P<0.05, P<0.01), 且LVEDP和STh在合用组显著低于两单用药组(P<0.05, P<0.01), 余指标在3个用药组间差异均无显著性(均P>0.05).结论:卡维地洛、西拉普利及其合用均能有效防治大鼠AMI左室重塑并改善血流动力学和左室功能,且以合用更佳。

Effects of carvedilol, cilazapril and their combination on left ventricular remodeling after acute myocardial infarction in rats

AIM:To compare the effects of carvedilol, cilazapril and their combination on left ventricular remodeling(LVRM) after acute myocardial infarction(AMI) in rats. METHODS: Twenty-four hours after AMI operation, 100 surviving rats were randomly assigned to: ①AMI control(n= 25), ②AMI+carvedilol(1 mg·kg^-1 ·d^-1, n= 25)(C1), ③AMI+cilazapril(1 mg·kg^-1 ·d^-1, n= 25)(Z1), and ④ AMI+combination(n= 25) groups. Sham-operated group(n= 17) were selected randomly. After 4 weeks of therapy with the drugs gastric gavage, hemodynamic and pathological studies were performed. RESULTS: There were no significant differences in MI size among the four AMI groups(all P> 0.05) Left ventricular(LV) end diastolic pressure(LVEDP), volume(LVV), weight(LVW) and septal thickness(STh) were all higher and left ventricular pressure maximal rate of rise and fall(±d p /d t) were lower(all P< 0.01) in AMI group than sham-operated group. The LVEDP, LVV, LVW and STh were all lower and ±dp /dt were higher in Z1, C1, and combination groups than those in AMI group(P< 0.05, P< 0.01), with LVEDP and STh were more lower in the combination group than in the two monotherapy group(P< 0.05, P< 0.01), but there were no significant differences in other variables among the three therapy groups. CONCLUSION: Carvedilol, cilazapril and their combination all can prevent from LVRM after AMI in rats, improve hemodynamics and LV function, with the combination superior.