肾性高血压患者左心室肥厚发生率及相关因素分析

目的：探讨肾性高血压患者左心室肥厚（LVH）的发生率及相关影响因素。方法：选取经临床和病理确诊为肾性高血压住院患者189例,记录患者的血压、体重指数（BMI）、肾脏病病程和高血压病程,并做心脏彩超计算患者左心室重量指数（LVMI）和左心室几何构型,并进行比较分析。结果：189例肾性高血压患者中,LVH发生率为48.7%;慢性肾脏病（CKD）1期患者肾功能正常时,LVH发生率为27.5%,在CKD5期达到70.5%;其中,左心室离心性肥厚51例（26.98%）,左心室向心性肥厚41例（21.69%）;Logistic多因素回归分析显示,高血压病程、收缩压和血红蛋白与肾性高血压患者发生LVH具有显著相关性（P〈0.05）。结论：LVH在肾功能正常的肾性高血压患者中己经存在,并且随着肾功能的减退患病率逐渐增加。肾性高血压最常见的左心室构型是离心性肥厚。高血压病程、收缩压和血红蛋白是肾性高血压患者发生LVH的主要危险因素。     

粉防己碱对DOCA盐性高血压心肌肥厚大鼠心脏血流动力学的影响

粉防己碱可显著降低DOCA盐性高血压心肌肥厚大鼠的血压,左室湿重;在工作心脏研究中发现其改善肥厚心室的收缩(AP,LVSP,+dp/dt_max)舒张(一dp/dt_max,LVEDP,T值)性能,尤以舒张性能改善明显,并恢复泵功能(CO)和冠脉流量(CF);在左室压力容积关系法研究显示有改善肥厚心室左室顺应性和左室僵硬度的作用。提示:Tet有逆转心肌肥厚和改善肥厚心肌舒张收缩功能,左室顺应性和心肌劲度的作用。     

粉防己碱逆转肾血管性高血压大鼠左心室肥厚并改善心功能

为观察粉防己碱对肾血管性高血压大鼠的心肌肥厚逆转作用以及对其离体工作心脏心功能和血流动力学情况的改善作用，采用二肾一夹肾型高血压形成大鼠左心室肥厚结果表明粉防己碱50 mg·kg^-1·d^-1 ig，治疗8周时，肾血管性高血压大鼠血压降至正常，其左心室湿重/体重指数较肥厚组降低22.5%; 在离体工作心脏，粉防己碱组心脏的舒张和收缩功能及心脏泵功能均明显改善，接近正常水平.结果说明粉防己碱对高肾素型高血压所致的左心室肥厚具有逆转作用，同时明显改善心脏的舒张收缩功能和血流动力学.     

粉防己碱逆转肾血管性高血压大鼠左心室肥厚并改善心功能

为观察粉防己碱对肾血管性高血压大鼠的心肌肥厚逆转作用以及对其离体工作心脏心功能和血流动力学情况的改善作用,采用二肾一夹肾型高血压形成大鼠左心室肥厚．结果表明粉防己碱５０ｍｇ·ｋｇ－１·ｄ－１ｉｇ,治疗８周时,肾血管性高血压大鼠血压降至正常,其左心室湿重／体重指数较肥厚组降低２２．５％;在离体工作心脏,粉防己碱组心脏的舒张和收缩功能及心脏泵功能均明显改善,接近正常水平．结果说明粉防己碱对高肾素型高血压所致的左心室肥厚具有逆转作用,同时明显改善心脏的舒张收缩功能和血流动力学．     

粉防已碱对肾型高血压左室肥厚大鼠心肌ATP酶活性的影响

AIM　Myocardial ATPase activities were assayed in tetrandrine treated two-kidney, one clip renovascular hypertensive(RH) rats with left ventricular hypertrophy(LVH). METHOD　Colorimetric method was used to measure the cardiomyocytic membrane Na , K -ATPase and mitochondrial Ca² -ATPase activities. RESULTS　In RH-LVH rats, the cardiomyocytic membrane Na ,K -ATPase and the mitochondrial Ca² -ATPase showed reduced activities. Tetrandrine 50mg^.kg^-1.d^-1 ig for 8 weeks elevated those two enzymatic activities significantly at the same time of reversing LVH. CONCLUSION　Tetrandrine, as a calcium channel blockers, can reverse LVH induced by RH and elevate the cardiomyocytic membrane sodium pump and mitochondrial calcium pump activities.     

四氢小檗碱对大鼠缺血及再灌注心肌的作用

四氢小檗碱（THB）及其同类物左旋四氢巴马汀，左旋千金藤立定能明显缩小麻醉大鼠心脏冠脉结扎4h后的梗塞范围，在Langendorff心脏，THB与维拉帕米能显著降低灌注心律失常的发生率，延长其潜伏期，并降低再灌注心肌中丙二醛含量及黄嘌呤氧休酶活力，提示THB具有保护缺血及再灌注心肌作用。     

小檗碱对改善大鼠动脉粥样硬化的影响及作用机制

目的:研究小檗碱对大鼠动脉粥样硬化的影响,并阐明其机制。方法:将30只大鼠随机分为5组,只饲基础饲料组作空白对照组(A),模型组(B)不予给药,C、D、E组给予不同剂量小檗碱,测定大鼠血液中TC、TG、LDL-C和HDL-C浓度,以及SOD活性和MDA水平。结果:给药大鼠与模型组相比较,TC、TG、LDL-C浓度明显降低(P<0.05),HDL-C浓度升高(P<0.05),SOD活性增强,MDA水平降低(P<0.05),SOD与MDA呈负相关。结论:小檗碱具有改善大鼠动脉粥样硬化的功效,可作为降血脂药应用于临床。     

粉防己碱对肾型高血压左室肥厚大鼠心肌ATP酶活性的影响

目的　观察粉防己碱对肾型高血压左室肥厚大鼠心肌 Ａ Ｔ Ｐ 酶活性的影响。方法　采用二肾一夹肾型高血压形成大鼠左室肥厚,用光电比色、无机磷显色法测定心肌细胞膜 Ｎａ＋ , Ｋ＋ Ａ Ｔ Ｐ 酶及线粒体 Ｎａ＋ , Ｋ＋ Ａ Ｔ Ｐ 酶、 Ｃａ２ ＋ Ａ Ｔ Ｐ酶活性。结果　左室肥厚组大鼠心肌细胞 Ａ Ｔ Ｐ 酶活性明显降低,粉防己碱５０ ｍｇ·ｋｇ － １·ｄ － １ｉｇ 连续给药８ ｗｋ 可逆转左室肥厚,显著增加心肌细胞膜 Ｎａ ＋ , Ｋ＋ Ａ Ｔ Ｐ 酶及线粒体 Ｃａ２ ＋ Ａ Ｔ Ｐ酶活性。结论　粉防己碱因其钙拮抗作用,在降低血压、逆转左室肥厚的同时,可使细胞膜钠泵活性、线粒体钙泵活性恢复     

小檗碱对2型糖尿病性神经痛大鼠疼痛的影响

目的：探讨不同剂量的小檗碱（Berberine，Ber）对2型糖尿病性神经痛（DEN）大鼠疼痛及血糖的影响。方法：实验采用高脂高果糖饲料喂养1个月，再用小剂量链脲佐菌素（STZ）诱导的方法建立2型糖尿病性神经痛大鼠模型，且随机将实验动物分为正常对照组、糖尿病对照组、低剂量组、高剂量组。正常对照组不予任何处理，糖尿病对照组以磷酸盐缓冲液（PBS）1ml／kg、低剂量组以小檗碱100m异，kg、高剂量组以小檗碱187.5mg／kg体重灌胃，整个治疗持续8周（w）。用热板法测定大鼠舔后足的潜伏期即痛阔，用血糖仪测空腹血糖（FBG）。结果：（1）建模成功后，模型大鼠FBG〉113．8mmol／L，痛阈值明显降低（P〈0．05）。（2）用小檗碱治疗后，低剂量组、高剂量组的FBG均较糖尿病对照组明显降低（R=0．05）；高剂量组的痛阈值较糖尿病对照组显著升高（P〈0．01）。（3）实验还发现，在用小檗碱治疗的后期能使明显消瘦的2型糖尿病性大鼠体重回升。结论：小檗碱可明显降低糖尿病大鼠的空腹血糖，且大剂量时对DPN大鼠的神经性疼痛有一定的改善作用。     

卡托普利对心肌梗死后左室重塑的影响

目的 探讨卡托普利(开搏通)与急性心肌梗死(AMI)后左室重塑的关系.方法 选择首次AMI患者70例,在发病后给予卡托普利治疗,应用彩色多普勒超声显像仪,于发病第4周和52周行超声心动图检查,观察左室形态、大小、室壁运动并记录左室收缩末期内径(LVDs)、舒张末期内径(LVDd)、左室收缩末期容积(LVESV)、左室舒张末期容积(LVEDV)、左室射血分数(LVEF)、左房内径(LAD)和二尖瓣血流频谱图中快速充盈E波最大流速(VE)和心房充盈A波最大流速(VA)等指标并计算VE/VA等指标.其中8例退出研究,将不规律应用卡托普利(n=29)和规律服用卡托普利(n=33)患者分为A、B 2组,比较52周时2组超声心动图观察指标.结果 B组的LVDs、LVDd、LVESV、LVEDV和LAD比A组降低,但LVEF和VE/VA比A组升高(P＜0.05).结论 卡托普利可以干预AMI后左室重塑,明显改善左室舒缩功能.     

辛伐他汀对大鼠心肌梗死后心室重塑影响的实验研究

目的探讨辛伐他汀对大鼠心肌梗死后心脏功能和心室重塑的影响。方法结扎大鼠冠状动脉前降支建立心肌梗死模型,24 h后存活大鼠随机分成心肌梗死组(M I组)、辛伐他汀20 mg组(20 mg.kg-1.d-1)和40 mg组(40 mg.kg-1.d-1),另单设假手术组(Sham组)。8 wk后测定血液动力学指标,血清血脂水平,心室重量指数,苦味酸天狼猩红染色后观察心脏形态学改变,测定心肌胶原容积分数。结果各组血脂水平无统计学差异;MI组心室重量指数增加,心脏收缩及舒张功能受损,梗死边缘区胶原沉积明显,胶原比例改变。两个辛伐他汀(simvastatin,Sim)组均能减轻心室重量指数,改善心脏功能,减少梗死边缘区胶原沉积。结论辛伐他汀能抑制心肌梗死后心室重塑,其机制可能与抑制心肌梗死后心肌肥大和心肌间质纤维化相关,而与其降脂作用关系不大。     

吲达帕胺在逆转急性心肌梗死左室重构中的作用

目的：通过给急性心肌梗死患者应用吲达帕胺（Ｉｎｄ）,观察其在逆转急性心肌梗死左室重构中的作用。方法：选择急性心肌梗死患者１１６例,随机分为Ｉｎｄ治疗组和对照组（各５８例）。用脉冲多普勒超声心动图测定等容舒张时间（ＩＶＲＴ）、二尖瓣口血流频谱、肺静脉血流频谱和左室射血分数。结果：Ｉｎｄ治疗组与对照组比较：ＩＶＲＴ、ＥＤＴ和ＡＲ波时间明显缩短;Ｅ／Ａ比值、Ｓ／Ｄ波幅比值、Ｓ／Ｄ时间比值和ＥＦ明显升高;     

Hydroxysafflor yellow A attenuates left ventricular remodeling after pressure overload-induced cardiac hypertrophy in rats

Context: Hydroxysafflor yellow A (HSYA), the main chemical component of the safflower yellow pigments, is used extensively in traditional Chinese medicine for the treatment of cerebrovascular and cardiovascular diseases.

Objective: The present study determined the effects of HSYA on left ventricular hypertrophy after pressure overload and investigated the underlying mechanisms.

Materials and methods: Cardiac hypertrophy was induced by the ligation of abdominal aorta in male Wistar rats. The rats were then divided into five groups and treated with captopril (100?mg/kg) or HSYA at different doses (0, 10, 20 and 40?mg/kg). Six weeks after treatment, the weight of left ventricle, LVMI (left ventricular mass index) and pathological changes were measured. MMP-2 (metalloproteinase 2) and MMP-9 (metalloproteinase 9) levels were determined by ELISA. Protein expressions of Bcl-2 and Bax were evaluated by immunohistochemistry.

Results: HSYA (20, 40?mg/kg) significantly attenuated the increase of LVMI (ventricular weight/body weight) by 13.04 and 30.43% respectively, when compared with the model group. This was associated with the amelioration of pathological lesion, such as cardiac muscle fibers were smaller and the nuclei of cardiomyocytes were lightly stained in animals treated with HSYA (20, 40?mg/kg). In addition, the administration of HSYA at doses of 20 and 40?mg/kg increased the Bcl-2/Bax ratio (1.17?±?0.08 and 1.39?±?0.07 versus 0.71?±?0.06). In addition, the serum MMP-2 and MMP-9 levels were blocked by the treatment at doses of 20 and 40?mg/kg HSYA (MMP-2, 76.1?±?9.2 and 65.6?±?6.8 versus 82.9?±?6.2, ng/ml; MMP-9, 66.6?±?4.8 and 57.5?±?5.0 versus 83.5?±?6.0, ng/ml).

Conclusion: These findings indicated that HSYA has beneficial effects on hypertensive ventricular remodeling, which may involve mechanisms of inhibiting cell apoptosis and suppressing metalloproteinases expression.     

卡维地洛对急性心肌梗死大鼠左室重构的影响

目的建立大鼠急性心肌梗死(acute myocardial infarction,AMI)模型,观察AMI后卡维地洛早期处理对心梗后左室重构的影响。方法雄性Wistar大鼠60只,随机分为假手术组(n=15)、AMI组(n=15)、低剂量卡维地洛组(n=15)和高剂量卡维地洛组(n=15)。建模后2周心肌组织取材,HE、Masson染色病理学检查;免疫组织化学测定心肌组织中毛细血管及抗凋亡、凋亡蛋白表达;建模前1 d及建模后2周心脏超声检查;采用Elisa法对建模前及建模后2周血浆脑钠肽(BNP)水平测定。结果建模后2周,与AMI组比较,卡维地洛组梗死面积减小,梗死区存活心肌细胞数增加,替代性纤维化面积减小,抗凋亡蛋白bcl-xl表达增强,凋亡蛋白Bax表达降低,P<0.05;梗死区及梗死旁区心肌组织中幼稚毛细血管密度增加,上述改变在高剂量药组明显;心脏超声左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)、室间隔厚度(IVS)直线小,心率(HR)减慢,左室射血分数(EF)值增加(P<0.05);血浆BNP水平较AMI组明显降低(P<0.05)。结论大鼠AMI后早期应用卡维地洛处理,可减少心肌细胞的凋亡及丢失,减轻AMI后心肌梗死程度,减轻左心室重构,改善AMI后左室功能,延缓心力衰竭的发生。     

前胡丙素对两肾两夹肾性高血压大鼠心脏重构及心功能的影响

目的研究前胡丙素长期灌胃给药对两肾两夹肾性高血压大鼠心脏、心功能及左室顺应性的影响。方法制作两肾两夹肾性高血压大鼠模型,前胡丙素20 mg.kg-1.d-1,连续灌胃给药9 wk,用离体大鼠工作心脏灌流法检测心功能及左室顺应性,W oessner等报道的方法测定心肌组织羟脯氨酸含量。结果与假手术对照组相比,肾性高血压左室肥厚(LVH)组大鼠CF/HWW和CO/HWW降低29.2%和38.5%,LVSP、-dp/dtm ax分别降低22.8%和43.2%;LV-EDP和T值增高172.9%和187.1%,LVEDP-V曲线左移上抬,左室肌胶原含量增加38.9%。前胡丙素组CF/HWW和CO/HWW比LVH组分别增加23.5%和37.2%,LVSP值和-dp/dtm ax负值较LVH组增加16.0%和42.7%,LVEDP和T值降低38.9%和39.0%,左室LVEDP-V曲线接近正常组水平,左室肌胶原含量降低18.9%,其作用与硝苯地平相似。结论前胡丙素可明显改善两肾两夹肾性高血压大鼠心脏舒张功能,改善心肌顺应性,同时也可改善心脏收缩功能,其作用可能是通过扩张冠状动脉,改善心肌缺血,降低心肌胶原含量而实现。     

超声评价瑞舒伐他汀对自发性高血压大鼠血压及左心室重构的影响

目的应用超声观察、评价单独或联合应用瑞舒伐他汀对自发性高血压大鼠左心室重构的影响,为临床应用提供理论依据。方法32只16周自发性高血压大鼠（SHR）,随机分成两组,每组16只：（1）瑞舒伐他汀组（R组）应用瑞舒伐他汀10mg／（kg·d）加2ml蒸馏水每天灌胃1次;（2）对照组2ml蒸馏水每天灌胃1次。分别于给药前及给药后2、4、6周测量大鼠尾动脉收缩压;给药前和给药6周后进行超声测量;进行左心重量及左室重量指数（LVMI）测定。结果（1）2、4、6周对照组大鼠血压较基础值显著升高,R组大鼠血压较基础值显著降低（P〈0.05或P〈0.01）。（2）治疗后,左心重量及LVMI,R组显著低于对照组（P〈0.05或P〈0.01）。与基础值比较,治疗后对照组LVEDD显著降低,IVSD、IVSS、LVPWD和LVPWS显著增加（P〈0.05或P〈0.01）;R组LVEDD显著增加（P〈0.05或P〈0.01）,IVSD、IVSS、LVPWD和LVPWS显著降低（P〈0.05或P〈0.01）。R组LVEDD显著高于对照组（P〈0.01）IVSD、IVSS、LVPWD和LVPWS显著低于对照组（P〈0.05或P〈0.01）。结论使用瑞舒伐他汀可改善自发性高血压大鼠左心室重构。     

liguzinediol对压力超负荷大鼠心室重构的影响

目的通过部分结扎大鼠肾上腹主动脉建立压力超负荷性心室肥厚模型,观察liguzinediol对各组大鼠心室重构的影响。方法用腹主动脉缩窄方法复制大鼠压力超负荷心室重构模型。设假手术组,模型组,liguzinediol高、中、低剂量(20、10、5 mg.kg-1)组及阳性药(卡托普利10 mg.kg-1)组。造模后稳定1周开始灌胃给药,给药8周后测量大鼠心脏动脉收缩压(SBP)、动脉舒张压(DBP)、平均动脉压(MAP)、左室收缩内压(LVSP)、左室舒张末期压(LV-EDP)、左心室内压最大上升/下降速率(±dp/dtmax);计算全心质量指数(HMI)以及左室质量指数(LVMI);HE染色光镜观察心肌结构;放射免疫法检测大鼠血浆中肾素活性(PRA)、血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD);碱水解法测羟脯氨酸(HYP)含量,ELISA法检测大鼠心肌组织Ⅰ/Ⅲ型胶原比值。结果 liguzinediol能明显降低压力超负荷致心室重构大鼠的HMI和LVMI,改善血流动力学参数,降低AngⅡ和ALD含量,降低HYP含量及Ⅰ/Ⅲ型胶原比值。结论 liguzinediol具有抑制实验性心室重构的作用,其机制与抑制心肌肾素-血管紧张素-醛固酮系统(RAAS)活性有关。     

Berberine attenuates adverse left ventricular remodeling and cardiac dysfunction after acute myocardial infarction in rats: Role of autophagy

The present study aimed to test the hypothesis that berberine, a plant‐derived anti‐oxidant, attenuates adverse left ventricular remodelling and improves cardiac function in a rat model of myocardial infarction (MI). Furthermore, the potential mechanisms that mediated the cardioprotective actions of berberine, in particular the effect on autophagy, were also investigated. Acute MI was induced by ligating the left anterior descending coronary artery of Sprague‐Dawley rats. Cardiac function was assessed by transthoracic echocardiography. The protein activity/levels of autophagy related to signalling pathways (e.g. LC‐3B, Beclin‐1) were measured in myocardial tissue by immunohistochemical staining and western blot. Four weeks after MI, berberine significantly prevented cardiac dysfunction and adverse cardiac remodelling. MI rats treated with low dose berberine (10 mg/kg per day) showed higher left ventricular ejection fraction and fractional shortening than those treated with high‐dose berberine (50 mg/kg per day). Both doses reduced interstitial fibrosis and post‐MI adverse cardiac remodelling. The cardioprotective action of berberine was associated with increased LC‐3B II and Beclin‐1 expressions. Furthermore, cardioprotection with berberine was potentially related to p38 MAPK inhibition and phospho‐Akt activation. The present in vivo study showed that berberine is effective in promoting autophagy, and subsequently attenuating left ventricular remodelling and cardiac dysfunction after MI. The potential underlying mechanism is augmentation of autophagy through inhibition of p38 MAPK and activation of phospho‐Akt signalling pathways.