厄贝沙坦对大鼠急性心肌梗死后血清脑钠肽及左心室功能结构的影响

Effects of irbesartan on brain natriuretic peptide serum levels and left ventricular remodeling in rats after acute myocardial infarction

目的通过动物实验了解血管紧张素受体拮抗剂厄贝沙坦对急性心肌梗死(AMI)后大鼠血浆中脑钠肽(BNP)及左心室功能和结构的影响。方法选用40只雄性Wistar大鼠,10只不结扎冠状动脉列为假手术组(A组);其余30只结扎其左冠状动脉前降支制备AMI模型,将存活的20只再随机分为对照组(B组)和厄贝沙干预组(C组)各10只。3组大鼠在14天内不同时间点取尾血检测BNP指标,同时测取14天时3组大鼠的左心室收缩压力(LVSP)、左心室舒张末压力(LVEDP)、左心室质量(LVM)、左心室质量指数(LVMI)及体质量(BM)5项指标。结果 3组大鼠BM差异无统计学意义(P>0.05)。3组血清BNP水平在组间、不同时间点及组间和不同时间点的交互作用差异均有统计学意义(均P<0.01);B组血清BNP呈双峰分泌,且第一峰峰值高于C组;C组血清BNP浓度只有一个峰值;A组血清BNP浓度变化较平坦。B组和C组LVSP均低于A组,但C组高于B组,分别为(103.60±3.19)mmHg,(107.45±2.96)mmHg vs(132.53±3.43)mmHg(均P<0.05);B组和C组的LVEDP、LVM、LVMI均高于A组,但C组低于B组,分别为LVEDP(10.97±0.89)mmHg,(6.39±0.67)mmHg vs(5.62±0.58)mmHg;LVM(676.80±34.93)mg,(614.10±27.77)mg vs(449.50±27.37)mg;LVMI 2.96±0.06,2.68±0.07vs 2.00±0.06(均P<0.05)。结论血清BNP升高参与了AMI后病情演变过程;厄贝沙坦能改善AMI后血清BNP升高的程度以及AMI后左心室功能及左心室重构的程度。

Objective To study brain natriuretic peptide（BNP） serum levels and left ventricular function and structure in rats after acute myocardial infarction（AMI） and to observe the effects of irbesartan（Irb） on them. Methods Forty male wistar rats were involved in the study. Ten rats （A group, n = 10） underwent sham operation and the rest 30 rats were made into AMI model by ligating left anterior descending coronary. The survived 20 AMI model rats were randomly divided into two groups：AMI group （B group, n =10） and AMI＋Irb （C group, n =10）. All rats were taken tail-blood to test BNP at different time points in subsequent 14 days and five indicators were measured： left ventricular systolic pressure（LVSP）,left ventricular end diastolic pressure（LVEDP）,left ventricular mass（LVM）, left ventricular mass index（LVMI） and body mass（BM）. Results The three parameters of C group were all higher than those of A group. There were no significant difference in BM among three groups （ P 〈 0.05）. The differences of interblock,time dissimilarity and interaction of interblock with time dissimilarity among three groups of BNP showed significant difference（all P 〈0.01）. The serum BNP level in B group had two peak values,while that in C group had one peak value. The first peak of the serum BNP level in B group was higher and earlier than that in C group. The serum BNP level in A group was smoother. LVSP of B group and C group were lower than that of A group, but that of C group was higher than of g group, （103.60 ± 3.19） mmHg, （107.45 ± 2.96） mmHg vs （132.53 ± 3.43） mmHg, respectively（all P 〈 0.05） ;LVEDP, LVM, LVMI of B group and C group were higher than those of A group, but those indexs of Cgroup were lower than those orB group, （10.97!0.89） mmHg,（6.39±0..67） mmHg vs （5.62±0.58） mmHg ;LVM（676. 804±34.93） mg,（614. 10±27.77） mg vs （449.50±27.37） mg±LVMI（2.96±0.06） mg/g, （2.68± 0.07） mg/g vs （2.00±0.06） mg/g, respectively（all P 〈0.05）. Conclusion The increase of serum BNP level participated in the progress of AMI. Irb could lessen BNP serum increase after AMI. At the same time, Irb can improve left ventricular pump function and left ventricular remodeling after AMI.