氯沙坦钾与螺内酯合用对大鼠急性心肌梗死后心室重构的影响

目的观察氯沙坦钾与螺内酯合用对大鼠急性心肌梗死后心室重构的影响。方法建立大鼠急性心肌梗死模型,将存活鼠随机分为氯沙坦钾组、螺内酯组、联合用药组及安慰剂组,并设假手术组。心肌梗死后6周,对各组大鼠均进行心功能、心室重构指标的检测;并同时测定各组大鼠非梗死区心肌组织中血管紧张素Ⅱ(AngⅡ)、醛固酮(Ald)水平。结果①氯沙坦钾组、螺内酯组及联合用药组全心重量/体重(VW/BW)、左室重量(LVW)、左室重量指数(LVWI)及心肌细胞横径(TDM)均较安慰剂组降低;联合用药组各指标降低更明显(P<0.05)。②氯沙坦钾组、螺内酯组及联合用药组AngⅡ、Ald水平较安慰剂组降低;联合用药组AngⅡ、Ald水平进一步降低(P<0.05)。结论急性心肌梗死后非梗死区心肌组织发生重构,螺内酯和氯沙坦钾均可通过抑制局部心肌组织AngⅡ和Ald水平而减轻心肌细胞的肥大程度、延缓心肌梗死后心室重构过程,而且螺内酯和氯沙坦钾合用还具有明显的协同效果。

Effects of spirolactone and losartan on the prevention of ventricular remodeling after acute myocardial infarction in rats

Objective To investigate the effects of spirolactone and losartan on the prevention of ventricular remodeling after acute myocardial infarction (AMI) in rats. Methods By establishing acute myocardial infarction model, the surviving AMI Wistar rats were randomly divided into control group , spirolactone treatment group , losartan treatment group , spirolactone plus losartan treatment group at 24 hours after MI .Sham operated rats were randomly selected .After 6 weeks of therapy , pathological analysis , the level of AngⅡ and Ald in noninfarction myocardium zone were performed. Results ①In losartan treatment group, spirolactone treatment group and combination treatment group , compared with control group , ventricular weight(VW)/body weight(BW) ratio , left ventricular weight (LVW), left ventricular weight index (LVWI),TDM was significantly decresed; The use of combination losartan and spirolactone treatment decresed more obvious compared with losartan treatment group and spirolactone treatment group (P<0.05); ②After losartan treatment, spirolactone treatment or combination losartan and spirolactone treatment , the level of AngⅡ and Ald in noninfarction myocardium zone was significantly decresed compared with control group in combination losartan and spirolactone treatment group, the level of AngⅡ and Ald decresed more obvious compared with losartan treatment group and spirolactone treatment group (P<0.05). Conclusion Losartan , spirolactone , combination losartan and spirolactone treatment may prevent ventricular remodeling after MI , the effection may be performed by inhibiting the level of AngⅡ and Ald in noninfarction myocardium zone.