部分缩窄大鼠腹主动脉致心室重构动物模型的病证结合研究

目的研究部分缩窄大鼠腹主动脉致心室重构模型的中医证候特点及心室重构特点。方法大鼠随机分为正常组、假手术组和模型组,采用部分缩窄大鼠腹主动脉致心室重构。应用中国中西医结合学会关于虚证和血瘀证辨证标准,观察术后动物的每周一般状态以及心率、力竭性游泳时间、心电图、超声心动图的变化,进行中医证候评价。结果模型组大鼠一般情况表现为虚症和血瘀证,术后4周与假手术组比较,模型组大鼠ST段发生异常的抬高或降低的导联数明显增加(P<0.01),心率明显增快(P<0.05)、力竭性游泳时间明显缩短(P<0.01)、室间隔舒张末期厚度(IVSTd)明显增加(P<0.01),左室心肌质量指数(LVM I)明显增加(P<0.01);术后8周与假手术组比较,模型组大鼠ST段发生异常的抬高或降低的导联数增加、心率增快、力竭性游泳时间的缩短、IVSTd、LVPWTd和LVM I的增加仍同4周时的改变性质,但LVDd发生显著性增加(P<0.05),EF也发生明显减小(P<0.05)。结论部分缩窄腹主动脉致心室重构大鼠中医证候表现有心气虚证及血瘀证的特点,血瘀证贯穿于病变整个过程,心气虚证随着病变的发展而出现并加重。该模型大鼠心脏早期左心室呈现典型的向心性肥厚的病理改变;造模8周后该模型呈既有向心性肥厚又有离心性肥厚的混合型左室肥厚。

Combination of disease and syndrome of ventricular restructure model induced by partial coarctation of abdominal aorta in rats

Objective To study the characteristics of TCM syndromes of the model of ventricular restructure and the characteristics of ventricular restructure induced by partial coarctation of abdominal aorta in rats.Methods The rats were randomly divided into the normal group,sham-operation group and model group.The ventricular restructure model was established by partial coarctation of abdominal aorta.With the standard of syndrome differentiation for deficiency syndrome and blood stasis syndrome of China Society of Integration of Chinese and Western Medicine,the general condition,heart rate,time of exhausted swimming,electrocardiogram,ultrasonograph of rat in every week were observed after the operation,and the TCM syndromes were evaluated.Results The general condition of the model group manifested as deficiency syndrome and blood stasis syndrome.In the model group,compared with the sham-operation group after 4 weeks,the heart rate(P<0.05) and number of variation ST-section were increased(P<0.01),but time of exhausted swimming(P<0.01)is shortened markedly.Inter ventricular septum thickness(IVSTd,P<0.01) and left ventricular mass index(LVMI,P<0.01) increased significantly.After 8 weeks in the model group,compared with the sham-operation group,the number of variation ST-section,heart rate,time of exhausted swimming,IVSTd,LVPWTd and LVMI were the same as those after 4 weeks,but LVDd(P<0.05) increased markedly and EF(P<0.05) decreased markedly.Conclusion The rat with left ventricular restructure induced by partial coarctation abdominal aorta had the TCM syndrome characteristics of heart-qi deficiency and blood stasis.The syndrome of blood stasis existed in the whole pathological cause,while the syndrome of heart-qi deficiency emerged and aggravated along with the disease development.The model had typical pathological changes of left ventricular concentric hypertrophy in early stage.After 8 weeks the model had left ventricular synthetic hypertrophy with not only concentric hypertrophy but also centrifugal hypertrophy.