螺内酯对心肌梗死后心肌细胞凋亡和增殖的影响

目的 探讨螺内酯对心肌梗死后细胞凋亡和增殖的影响.方法 45只SD大鼠随机分为3组：假手术（SHAM）组、心肌梗死（Myocardial infarction,MI）组和心肌梗死后螺内酯（Spironolactone,SPI）干预组.测量左心室功能,光镜观察标本病理形态改变,缺口末端标记法（TUNEL）检测细胞凋亡程度,免疫组化观察细胞增殖核抗原（PCNA）表达.结果 MI组心功能较SHAM组明显下降,SPI组较MI组改善;SHAM组心肌结构完整,MI组心肌结构损害严重,SPI组心肌结构损害较轻;与SHAM组相比,MI组凋亡细胞数显著增加;与MI组相比,SPI组心肌细胞凋亡数显著减少（P＜0.01）.与SHAM组相比,MI组PCNA表达显著增加;与MI组相比,SPI组PCNA表达无明显差异 结论 螺内酯改善心室重构和心力衰竭主要通过抑制细胞凋亡而非心肌细胞的增殖.

Effect of spironolactone on cardiomyocyte apoptosis and proliferation after myocardial infarction

Objective To investigate the effect of spironolactone on myocardial cells apoptosis and prolifera tion in the rat heart after myocardial infarction（MI）. Methods SpragueDawley rats were divided into three groups： sham,untreated MI, spironolactonetreated MI groups. The heart function was measured and the pathological changes were observed by light microscope. Myocardial apoptosis was determined by TUNEL stain. The expression of PCNA in the myocardium was measured by immunohistochemistry. Results Cardial function in group MI was the lowest com pared to the other two groups, while group SPI was higher than that of group MI. The cardiomyocytes injuries were more severe in group MI than those in group SPI. The number of apoptosis cells significantly increased in the group MI and spironolactone markedly inhibited myocardial cells apoptosis after MI（ P 〈 0. 01 ）. Compared with sham group,PC NA in MI group significantly increased,but SPI group had no significant difference compared with untreated MI group. Conclusion Spironolactone favors postinfarct ventricular remodeling by inhibiting myocardial cells apoptosis,rather than suDDressine their nroliferation.