内皮细胞损伤及功能变化在心肌缺血再灌注中的意义及药物干预

Significance of Endothelial Cell Injury and Functional Changes in Myocardial Ischemia Reperfusion and Therapeutic Effect of Captopril

目的：探讨内皮细胞损伤及功能变化在心肌缺血再灌注损伤中的发病机制及卡托普利对其的影响。方法：实验兔分为心肌缺血再灌注组（ｎ＝８），心肌缺血再灌注＋卡托普利治疗组（ｎ＝８）及假手术对照组（ｎ＝８）；分别测结扎前，缺血０．５小时，再灌注０．５小时、１．５小时和６小时共５个时相点。用放射免疫法测定血浆内皮素（ＥＴ），紫外分光光度计测一氧化氮（ＮＯ），Ｐｅｒｃｏｌ密度梯度离心法分离血循环内皮细胞。结果：心肌缺血０．５小时，血中ＥＴ、ＮＯ含量无明显变化，于再灌注０．５小时ＮＯ下降、ＥＴ升高，尤以再灌注１．５小时和６小时变化显著（Ｐ均＜０．０５）。循环内皮细胞则以再灌注１．５小时明显增高（Ｐ＜０．０５）。卡托普利可逆转上述指标。结论：再灌注导致内皮功能紊乱，进而加重内皮细胞损伤，二者互为因果关系，卡托普利通过保护内皮而减轻再灌注损伤。

Objective:To study the damage and functional changes of endothelial cells (EC) during the process of myocardial ischemia reperfusion(MI/R) and the therapeutic effect of captopril. Methods:The rabbits were randomly divided into 3 groups ( n =8 in each),MI/R groups (A),captopril group(B) and sham operated group(C).Plasma endothelin (ET),nitric oxide (NO,in terms of NO - 2),and circulating endothelial cells (CEC) were measured before ligation,0 5 h after ischemia,and 0 5,1 5 and 6 h after reperfusion. Results:As compared with group C,NO decreased and ET increased in 0 5 h ( p <0 05) and more significant in 1 5 h and 6 h after reperfusion ( p <0 01).The number of CEC increased 1 5 h after reperfusn ( p <0 01);captopril reversed the results of mentioned biochemical indices markedly. Conclusion:The reperfusion results in the dysfunction of the endothelium,and then injures the endothelial cells more severely.Captopril reduces the reperfusion injury by protecting endothelium.