缬沙坦、苯那普利及两者合用对大鼠实验性心肌梗死后心功能的影响

目的 :对比血管紧张素转换酶抑制剂 (ACEI)、选择性I型血管紧张素II受体拮抗剂 (ARB)及两者合用对心肌梗死 (MI)后的早期左室重构过程中心功能的影响。方法 :将冠状动脉结扎术后24h存活的SD大鼠随机分为苯那普利组 (B组 )、缬沙坦组 (V组 )、苯那普利 +缬沙坦组 (B +V组 )和空白对照组 (C组 ) ,假手术组 (S组 )作为正常对照。治疗6周后测量血流动力学指标及血清醛固酮 (Ald)和血管紧张素II(AngII)的浓度。结果 :MI后6周C组与S组相比 ,左室压力最大上升速率( +dp/dtmax)和左室压力最大下降速率(_dp/dtmax)显著降低 (P<0.01) ,而左室舒张末压 (LVEDP)显著升高 (P<0.01) ;3治疗组中以上指标得到相似程度改善 ,并使LVEDP恢复至正常(分别与C组比较 ,均P<0.01 ;与S组比较 ,P>0.05)。与S组相比 ,C组血清AngII无明显变化 ,而Ald显著升高 ,治疗组中除V组的血浆AngII显著升高外 ,其余均显著降低 ,且血清Ald浓度与LVEDP呈显著正相关。结论 :(1)ACEI、ARB均有改善MI后受损心功能的作用。(2)合用ACEI与ARB具有良好的叠加作用。(3)血浆Ald是较AngII更持久的心功能不全的标志

Comparative Effects of Benazepril, Valsartan and Combination of Them on Postinfarcted Cardiac Function

Objective:To compare the effects of Angiotensin-converting enzyme inhibitors(ACEI),selective angiotensin II type 1 receptor blocker(ARB)and combination of them on left ventricular(LV)function in experimental myocardial infarction(MI)rats in the course of early ventricular remodeling.Methods:Twenty_four hours after deligation of coronary artery,SD rats were randomly divided into benazepril(B group),Valsartan(V group),combination of benazepril and valsartan(B+V group)and control group(C group).Sham operated rats(S group)served as control.After 6 weeks of the treatment,LV end_diastolic pressure (LVEDP),maximum rate of rise and fall of LV systolic pressure(+dp/dt max,_dp/dt max),as well as concentration of serum aldosterone(Ald)and angiotensin II(Ang II)were measured.Results:In C group,+dp/dt max,_dp/dt max significantly decreased(P<0.01),whereas LVEDP increased(P<0.01).In the three treatment groups,these parameters were similarly improved,and LVEDP returned to the normal compared with C group and S group(P<0.01,P>0.05,respectively).Compared with s group,there is no change of serum Ang II in C group,aldosterone increased,and all Ang II decreased significantly by all the treatments but for V group which was much higher than that in other groups.Furthermore concentration of serum Ald was positively correlated to LVEDP.Conclusion:(1)Both ACEI and ARB improve in postinfarcted cardiac function.(2)Combination of ACEI and ARB has a preferably additive effect.(3)Compared with serum Ang II,Ald is a more persistent marker in postinfarcted dysfunction.