培哚普利对大鼠心肌梗死后心肌细胞凋亡及心功能的影响

目的：探讨大鼠心肌梗死后心肌细胞凋亡和心功能的变化及培哚普利干预的影响。方法：结扎大鼠左冠状动脉前降支建造心肌梗死模型，成功后随机分为培哚普利干预组（A组，n=16）和心肌梗死组（B组，n=16），另设假手术组为对照（C组，n=16）。术后24h起各组分别予培哚普利（A组）和蒸馏水（B、C组）灌胃，6周后TUNEL法检测各组大鼠非梗死区心肌组织中心肌细胞凋亡指数的情况、实时荧光定量PCR法检测凋亡调控基因P53mRNA含量的变化，并以超声心动图评价大鼠心功能。结果：6周后A、B两组与C组相比心肌细胞凋亡指数、P53mRNA含量及左室舒张末期内径均显著升高（P〈0．05），而左室短轴缩短率和左室射血分数显著降低（P〈0．05）；A组与B组相比中心肌细胞凋亡指数、P53mRNA含量和左室舒张末期内径明显下降，而左室短轴缩短率和左室射血分数明显升高（P〈0．05）。结论：大鼠心肌梗死后心肌细胞凋亡指数及凋亡相关基因P53mRNA的表达显著升高，左室功能明显下降；培哚普利能降低P53mRNA的表达，减少心肌细胞凋亡，改善左室功能。

Effect of perindopril on myocyte apoptosis and left ventricular function after myocardial infarction in rats

Objective To study the effect of perindopril on myocyte apoptosis and left ventricular function after myocardial infarction in rats. Methods After the model of myocardial infarction was established by ligating the left anterior descending coronary of rats, the survivals were randomly divided into group A (perindopril group, n=16) and group B (myocardial infarction group, n=16). Meanwhile, the other 16 shame operation rats were as control group(group C, n=16). Each group was treated by direct gastric gavage from the second day, and rats of group A was treated with perindopril, group B and C with pure water. Six weeks later, the myocyte apoptosis index was detected with TUNEL and the expression of P53 mRNA with real-time fluorescent quantitative PCR. In addition, all the rats were checked left ventricular end-diastolic diameter, left ventricular ejection fraction, and fractional shortening with echocardiography.Results Compared with group C, there was a significantly increase of apoptosis index, expression of P53 mRNA and left ventricular end-diastolic diameter in group A and B (P<0.05). The left ventricular ejection fraction and fractional shortening were apparently reduced (P<0.05). Compared with group A and B, the apoptosis index, the level of P53 mRNA expression and left ventricular end-diastolic diameter in group B were higher than group A(P<0.05), and the left ventricular ejection fraction, fractional shortening were significantly lower (P<0.05). Conclusion After myocardial infarction, the apoptosis index and the expression of P53 mRNA in myocardium are increased distinctly, and the left ventricular function is remarkably decreased. Perindopril, which can reduce the expression of P53 mRNA and the number of cell apoptosis, can effectively improve left ventricular function in rats.