复方芪丹液对中国小型猪急性心肌梗死后早期心室重构的影响

Effect of Compound Qidan Liquid on Early Ventricular Remodeling after Acute Myocardial Infarction in Chinese Mini-pigs

目的从血流动力学和心肌胶原增生等方面探讨复方芪丹液干预急性心肌梗死(AMI)后心室重构(VR)的作用机理。方法结扎中国小型猪冠状动脉左前降支造成AMI模型,随机分为假手术组、模型组、复方芪丹液大、小剂量组和开搏通组,分别灌胃不同药物或生理盐水。4周后观察小型猪血压(BP)、左室内压(LVP)、左室内压上升最大速率(dp/dtmax)、心肌组织肾素、AngⅡ、总胶原、Ⅲ型前胶原、Ⅳ型胶原及层粘连蛋白含量,血清透明质酸及心肌组织病理改变。结果与模型组比较,中药大剂量组LVP、BP、dp/dtmax值明显升高,心肌层粘连蛋白和AngⅡ含量明显降低(P<0.05,P<0.01);中药小剂量组LVP显著升高(P<0.05);开博通组LVP及dp/dtmax值显著升高,心肌AngⅡ含量明显降低(P均<0.05);各给药组血清透明质酸水平及心肌总胶原均有显著下降(P<0.01)。Ⅲ型前胶原和Ⅳ型胶原水平各组间差异无统计学意义。结论复方芪丹液可提高中国小型猪AMI 4周后LVP、dp/dtmax,增加心肌收缩力,改善血流动力学,降低心肌AngⅡ水平,减少胶原沉积,进而减轻AMI后VR。

Objective To investigate the mechanism of Compound Qidan Liquid （CQD） for intervening ventricular remodeling （VR） after acute myocardial infarction （AMI） in Chinese mini-pigs from hemodynamic and collagen metabolic views. Methods AMI model of Chinese mini-pigs was established by left anterior descending （LAD） coronary artery ligation. The model pigs were then randomly divided into the sham-operative group, the model group, the captopril group, the high and low dose of CQD （hCQD and lCQD） groups, the former two were treated with normal saline and the latter three treated with corresponding drugs by gastrogavage for 4 weeks after modeling. Blood pressure （BP）, left ventricular pressure （LVP）, maximum ascending velocity of left ventricular pressure （ dp/dtmax ）, myocardial renin （ MCR）, angiotensin （ Ang Ⅱ ）, total collagen （ TC ）, procollagen type Ⅲ （ PC Ⅲ ）, collagen type Ⅳ （ C Ⅳ） , laminin （LM） , serum hyaluronic acid （HyA） as well as pathologic changes in myocardium were observed. Results As compared with in the model group, levels of BP, LVP and dp/dtmax were significantly higher, LM and Ang Ⅱ were lower in the hCQD group （P 〈0. 05 or P 〈0. 01 ） ; LVP was higher in the ICQD group （ P 〈 0. 05 ） ; LVP and dp/dtmax were higher, Ang Ⅱ was lower in the captopril group （ P 〈 0. 05 ）. Besides, levels of HyA and TC were lower in all the three medicated groups （ P 〈 0. 01 ）, while the differences of PC Ⅲ and CⅣ among groups were insignificant. Conclusion CQD has a beneficial effect in Chinese mini-pigs after AMI for increasing LVP and dp/dtmax, improving myocardial contractility and hemodynamic condition, decreasing myocardial Ang Ⅱ contents, decreasing deposition of collagen so as to alleviate thepathological process of VR afterAMI. pathological process of VR after AMI.