血管紧张素转换酶抑制剂对心脏移植后冠状血管增殖病变的影响

Effect of ACEI on proliferative coronary disease after heart transplantation

目的通过建立大鼠心脏移植后冠状血管增殖病变的模型,观察血管紧张素转换酶抑制剂(ACEI)对心脏移植后冠状血管增殖病变的影响。方法设立对照组、结扎组、ACEI+结扎组,观察2周后各组大鼠血液、心肌AngⅡ含量,心肌AngⅡ受体密度,及血管病理学结果。结果各组血液AngⅡ含量差异无统计学意义,结扎组心肌AngⅡ含量明显增高(17．42±5．49)fmol／mg．蛋白P<0．001比对照组,ACEI+结扎组AngⅡ含量明显下降(5．35±1．95)fmol／mg。蛋白P< 0．01比结扎组,结扎组AngⅡ受体密度增高(48．80±4．32)fmol／mg蛋白P<0．01比对照组,ACEI +结扎组内膜增生比结扎组明显减轻[内膜厚度(21．01±4．55)μm比(60．34±9．32)μm,P< 0．01)。结论心脏局部肾素-血管紧张素系统,AngⅡ及AngⅡ受体参与移植后冠状血管病变,A- CEI明显抑制移植后冠状血管病增殖变。

Objective To study the effect of ACEI on proliferative coronary artery disease after heart transplantation. Methods Posttransplantation rats were randomly divided into 3 groups： control group,ligation group and ACEI plus ligation group （ACEI group）. In the 3 groups, changes of Ang Ⅱ contents in plasma and myocardium, density of Ang Ⅱ receptor in myocardium and vascular pathological results were observed. Results There was no significant difference in the contents of plasma Ang Ⅱ among the three groups. The content of myocardial Ang Ⅱ in ligation group was 17.42 ± 5.49 fmol/mg protein, which was significantly higher than in control group （P 〈 0.01 ）, and that in ACEI group was 5.35 ± 1.95 fmol/mg protein, which was significantly lower than in ligation group （ P〈 0.01 ）. The density of Ang Ⅱ receptor in ligation group was 48.80 ± 4.32 fmol/mg protein,which was significantly higher than in control group （ P 〈0.01 ）. Vessel intimal thickness in ACEI group was significantly less than in ligation group （21 . 01 ± 4.55 μm vs 60.34 ± 9.32 μm,P〈 0.01） , Conclusion The heart regional RAS system and Ang Ⅱ and Ang Ⅱ receptor are involved in the proliferative coronary disease after heart transplantation. ACEI can inhibit significantly the intimal hyperplasia of coronary artery after heart transplantation.