葛根素注射液联合厄贝沙坦对心室快速起搏心力衰竭实验犬心房颤动及心房纤维化的影响

The influence of puerarin injection combined with irbesartan on atrial fibrillation and r induced by ventricula fibrous ventricular rapid pacing heart failure in dogs

目的观察葛根素注射液联合厄贝沙坦对心室快速起搏致充血性心力衰竭（congestive heartfailure，CHF）实验犬心房颤动及心房纤维化的影响。方法选择健康成年杂种犬21只，随机令为正常组对照组、cI—IF模型组和TMP治疗组。采用右心室快速起搏建立实验犬CHF模型。Butst刺激诱发心房颤动（atrial fibrin；tripn，LVEF）。超声心动图仪检测实验犬左心室射血分数（1eft ventricular ejection fraction，LVEF）。Mallory’s三色法染色检测心房组织纤维比程度。采用放射免疫法测定血桨血管紧张素1[和醛固酮的浓度，测定血清m型前肢原氨基末端肽（amino．tedllldall～eptldcoflype Ⅲ procollagen，PⅢNP）、层粘连蛋白（lalTlmln，I．N）和透明质酸（hyaltlronlcacid，HA）的水平。结果CHF模型组LVEF较正常对照组明显下降（P〈0．01）；AF发生率、持续性AF发生率及AF持续时间较正常对照组均明显增加（P〈0．01）；左右心房纤维化程度较正常对照组亦有明显增加（P〈0．01）；AF持续时间与左心房纤维比程度呈密切正相关（r=0．84，P=0．018）；血浆血管紧张素Ⅱ、醛固酮以及血清PⅢNP、HA水平较正常对照组均有明显升高（P〈0．05或P〈0．01）；LN比较则无统计学差异；血浆血管紧张素Ⅱ水平与醛固酮水平均呈密切正相关（r=0．759，P=0．182）。治疗组LVEF较亡I-IF；模型组有明显改善（P〈0．05）；持续性AF发生率较CHF模型组有明显降低（P〈G．05）；左右心房纤维化程度较CHF模型组均有明显减轻（P〈0．01）。结论葛根素注射液联合厄贝沙坦可减轻Ⅱ-IF时心房纤维比的程度，这可能是其减少CHF时AF发生率及持续时间的机制之一。

Objective To observe the combined effects of puerarin injection and irbesartan on congestive heartfailure （CHF） in dogs with ventricula fibrous ventricular rapid pacing heart failure. Methods 21 healthy mongrel dogs were randomly divided into normal control group, CI-IF model group and the TMP treated group. CHF was established by right ventricular pacing model of canine. Butst was used to evoke atrial fibrillation （atrial fibrill;tripn,LVEF）. Echocardiography was used to detect left ventricular ejection fraction in dogs（ Left ventricular ejection fraction, LVEF）. Mallory＇ s three-color staining was used to detect the degree of atrial fiber. The level of plasma angiotensin 1, aldosterone concentration, m-type forelimb of the original N-terminal peptide （ amino-terllllrlall ~ eptldcoftype HI procollagen, P HI NP）, laminin （ 1 alTlmln, IN）, and hyaluronic acid （ hya- ltlronlcacid, HA）was detected with radioimmunoassay. Results The LVEF of CHF model group decreased sig- nificantly compared with the control group （P 〈 0.01 ）. AF incidence, the incidence of persistent AF and AF duration were significantly inereased when compared with the control group （P 〈 0. 01 ）. Left atrial fibrosis were also signifieanfly increased in CHF model group than normal control group（P 〈0.01 ）. AF duration was positively correlated with the degree of left atrial fiber（ r = 0. 84, P = 0. 018 ）. plasma angiotensin Ⅱ , aldosterone, and serum P Ⅲ NP, HA levels were significantly higher than normal control group（ P 〈 0. 05 or P 〈 0. 01 ）. There was no statistical difference in LN. Plasma angiotensin II and aldosterone levels showed a close positive correlation（ r =0. 759 ,P =0. 182）. There is significant improvement in LVEF in treatment group when compared with model group（P 〈0.05 ）. The incidence of persistent AF was significantly lower in treated group when compared with CHF model（ P 〈 0. 05 ）. The left atrial fibrosis was significantly reduced in treated group when compared with CHF（ P 〈0. 01 ）. Conclusion Puerarin injection combined with irbesartan can reduce II-IF degree of atrial fiber,which may be one of the mechanisms of the reduction of the incidence and duration of CHF and AF.