早期应用活血和益气中药抑制心衰大鼠左室重构和凋亡的对比研究

目的：比较早期应用活血、益气中药,抑制心梗后心衰大鼠左室重构和心肌细胞凋亡的作用特点。方法：结扎大鼠左冠状动脉致心梗后心力衰竭,随机分为模型组、活血组(8 g·kg^-1)、益气组(8 g·kg^-1)、气血组(16 g·kg^-1)、西药组(卡托普利10.125 mg·kg^-1),另外有假手术组作为对照。于大鼠心梗后次日给药、疗程分别为4,8周。采用阻抗法测定心功能；病理染色图象分析测定左室腔周长和面积、单位面积内心肌细胞核数、单位面积内胶原的含量；TUNEL法测定心肌细胞凋亡百分率以及放射免疫法测定心肌组织中血管紧张素Ⅱ(AngⅡ)的含量。结果：各治疗组都改善了心衰大鼠左室收缩功能、减小左室腔面积、抑制胶原增殖、AngⅡ含量和心肌细胞凋亡,与模型组比较有显著差异；活血组给药8周改善心脏指数(CI)、减小左室腔面积、降低心肌AngⅡ的结果与假手术组已无显著性区别；活血组心肌细胞凋亡率显著低于益气药组。结论：活血、益气中药均有抑制心衰左室重构和心肌细胞凋亡,延缓心衰发展的作用,且活血组8周的效果最佳。

Comparative study on early application of the recipe for activating blood circulation and the recipe for supplementing qi for inhibiting left ventricular remodeling and apoptosis in rats with heart failure

OBJECTIVE: To compare the characteristics of early application of the recipe for activating blood circulation and the recipe for supplementing qi for inhibiting left ventricular remodeling and apoptosis in rats with heart failure. METHOD: The left coronary artery occlusion was conducted to establish the rat model of heart failure after myocardial infarction. The model rats were randomly divided into 5 groups, including model group, activating blood circulation group (8 g x kg(-1)), supplementing qi group (8 g x kg(-1)), activating blood circulation plus supplementing qi group (16 g x kg(-1)), and captopril group (10.125 g x kg(-1)), and a sham operation group was set up as negative control group. The drugs were administrated on the second day after myocardial infarction with a therapeutic course of 4 weeks or 8 weeks. The heart function was detected by impedance method; Pathological staining and image analysis were used to determine the perimeter and the area of left ventricular cavity, and myocardial nuclei number and collagen content per unit area; Apoptosis percentage of the myocardial cell was detected by TUNEL and the content of Ang II in the cardiac muscle was measured by radioimmunoassay. RESULT: In comparison with the model group, the function of left ventricular contraction function improved, the area of left ventricular cavity diminished, and proliferation of collagen, content of Ang II and apoptosis percentage of the myocardial cell reduced in all of the treatment groups (P < 0.05 or P < 0.01). After treatment of 8 weeks, the activating blood circulation group was similar to the sham operation group in improvement of cardiac index, and decreases of the area of left ventricular cavity and the content of Ang II; Apoptosis percentage of the myocardial cell in the activating blood circulation group was significantly lower than that in the supplementing qi group. CONCLUSION: Both the recipes for activating blood circulation and for supplementing qi can inhibit left ventricular remodeling and myocardial apoptosis, and delay development of heart failure, with the best effect in the activating blood circulation group after treatment of 8 weeks.