依那普利并氨氯地平对高血压大鼠血压及心血管结构的作用

①目的研究依那普利并氨氯地平对压力超负荷高血压大鼠血压、心肌纤维化与左室肥厚的影响.②方法将雄性Wistar大鼠随机分为5组,假手术组(S组)、手术组(O组)、依那普利组(E组)、氨氯地平组(A组)、联合用药组(C组).除假手术组只游离腹主动脉外,其余各组大鼠均行腹主动脉部分结扎术.S、O组分别将自来水5mL给大鼠灌胃,E、A组分别将20mg/kg依那普利和10mg/kg氨氯地平溶于5 mL自来水中给大鼠灌胃,C组将20mg/kg依那普利和10mg/kg氨氯地平给大鼠灌胃.术前及术后测大鼠血压,术后6周测定大鼠左心室质量指数(LVMI)、心肌胶原含量、心肌细胞凋亡指数(APOI)、心肌胶原容积分数(CVF)、心肌小动脉周围胶原面积与管腔面积比值(PVCA)、胸主动脉中膜/内径比值.③结果术后6周手术组大鼠心脏明显增大,左心室腔明显缩小,心肌显著肥厚.O组血压、LVMI、心肌胶原含量明显升高,与S组比较差异有显著性(F＝42.65～248.90,q＝16.27～38.32,P＜0.01);各用药组LVMI及心肌胶原含量低于手术组,差异有显著性(q＝5.44～69.56,P＜0.01);C组LVMI和心肌胶原含量低于A、E组,差异有显著性(q＝4.88～14.33,P＜0.01).各组APOI、CVF、PVCA和中膜/内径比值比较,差异有显著性(F＝12.52～172.06,P＜0.01);O组APOI、CVF、PVCA和中膜/内径比值高于S、E、A、C组,差异有显著性(q＝3.80～33.45,P＜0.05、0.01);C组APOI、CVF、PVCA及中膜/内径比值低于E、A组,差异有显著性(q＝3.25～14.42,P＜0.05、0.01).④结论依那普利与氨氯地平联用能有效逆转高血压引起的心血管肥厚,并具有较好的抗心肌细胞凋亡和心肌纤维化及降低血压的作用.

THE EFFECT OF COMBINATION OF ENALAPRIL AND AMLODIPINE ON HYPERTENSIVE RATS AND THEIR CARDIOVASCULAR STRUCTURE

Objective To study the effects of combination of Enalapril and Amlodipine on the blood pressure, fibrosis of myocardium and pachynsis of left cardiac ventricle of over-stress hypertensive rats. Methods The Wistar rats were divided randomly into the following five groups: Group F ( false-operation group), Group O (operation group), Group E (Enalapril group), Group A (Amlodipine group), and Group C (combination group). The abdominal aorta of the rat in Group F was mobilized only, for the rest groups, a partial ligature was done for the aorta. 5 mL of tap-water was injected into the stomach of each rat in Groups F and O; 20 mg/kg of Enalapril, dissolved in 5mL of tap-water, was injected into each rat's stomach in Group E, 10 mg/kg of Amlodipine for the rat in Group A and 20 mg/kg of Enalapril plus 10 mg/kg of Amlodipine for Group C per rat. The blood pressure was taken before and after operation. Six weeks later, the LVMI, level of collagen in myocardium, APOI, CVF and PVCA were detected. Results The examination revealed that the heart of the rats in Group O was enlarged, the cavity of left ventricle decreased, and marked pachynsis of myocardium shown. The blood pressure, LVMI and level of myocardiac collagen were also increased in rats of Group O. Comparing with Group F, the difference was significant (F=42.65-248.90, q=16.27-38.32, P<0.01); the LVMI and collagen level in myocardium in groups using the medicine were lower than those of Group O, the difference was obvious (q=5.44-69.56, P<0.01); the LVMI and collagen of myocardium in Group C were lower than Groups A and E, showing markedly different between them (q=4.88-14.33, P<0.01). The difference among the groups was significant in terms of APOI, CVF and PVCA (F=12.52-172.06, P<0.01); the APOI, CVF and PVCA of Group O were higher than those of Groups F, E. A and C, the difference was of markedly significant (q=3.80-33.45; P<0.05, 0.01); the APOI, CVF and PVCA were lower than those of Groups E and A (q=3.25-14.42; P<0.05, 0.01). Conclusion The combined use of Enalapril and Amlodipine may efficiently improve the cardiovascular pachynsis caused by hypertension and has an action of anti-apoptosis for the cells of myocardium, against fibrosis of myocardium and lowering blood pressure.