合用卡托普利和氯沙坦对大鼠急性心肌梗死后梗死区胶原修复及早期左心室重构的影响

目的探讨大鼠急性心肌梗死(AMI)后早期联用血管紧张素转化酶抑制剂(ACEI)和血管紧张素受体拮抗剂(ARB)对梗死区生长因子及胶原浓度的影响以及继而对左心室重构的影响。方法AMI大鼠随机分成对照组、卡托普利组和合用组,用药14d后测定梗死区及非梗死区血管紧张素Ⅱ(AngⅡ)、转化生长因子-β1(TGF-β1)及羟脯氨酸含量、心功能、左心室容积及重量。结果合用组梗死区AngⅡ、羟脯氨酸含量低于卡托普利组,TGF-β1也有减低趋势,而非梗死区AngⅡ、TGF-β1及羟脯氨酸含量2组间无差异。用药组对心脏功能的影响差异无显著性,合用组左心室舒张功能有低于卡托普利组的趋势;合用组左心室重量大于卡托普利组,但2组左心室容积差异无显著性。结论AMI后早期联用ACEI和ARB降低梗死区生长因子及胶原含量,不利于梗死区修复和左心室的较早期重构。

Effect of losartan and captopril on collagen accumulation and early remodeling after AMI

Objective:To evaluate if the early usage of losartan and captopril decrease growth factors and collagen accumulation at infarct region and the their effect on early remodeling. Method:LAD was ligated in 60 male rats. All rats survived the first 12 hours were randomized into control group, captopril group, captopril and losartan group. 14 days after AMI,hemodynamic studies were performed,the volume and weight of left ventricular,and the content of AngⅡ, TGF-β,and hydroxyproline of infarct scar and noninfarct myocardium were examined.Result:Compaired with captopril group, the content of AngⅡ of captopril and losartan group was decreased at infart scar but not noninfart myocardium,the contents of hydroxyproline also decreased, and the content of TGF-β1 nonsignificantly decreased; there were no siginificant differences in the content of TGF-β1 and hydroxyproline between the two group at noninfart myocardium. Distolic function of LV of captopril and losartan group decreased nonsignificantly compared with captopril group; LV weight of captopril and losartan group was greater than captopril group,whereas there were no significant differences in LV volume between these two groups.Conclusion:Early usage of losartan and captopril decreased growth factors and collagen at infarction region during early healing phase,promoted adverse LV remodeling.