依那普利和氯沙坦对心肌梗死大鼠心室重构影响的比较

Comparative Effects of Enalapril and Losartan on Cardiac Remodeling in Experimental Myocardial Infartion Rats

目的 研究比较血管紧张素转换酶抑制剂(ACEI)及选择性血管紧张素Ⅱ受体拮抗剂(AT_1受体拮抗剂)对心肌梗死大鼠心室重构的影响.方法Wistar大鼠冠脉结扎制成心肌梗死模型,24小时后随机分为依那普利(enalapril)治疗组,氯沙坦(losartan)治疗组,安慰剂(placebo)组,治疗6周.假手术组为对照.6周后测定体重、梗死区重量、心脏重量/体重、血浆及心肌的血管紧张素Ⅱ(AngⅡ)浓度、心肌胶原含量及血浆内皮素浓度.结果enalapril及losartan治疗组中心脏重量/体重及心脏胶原含量高于假手术组,而低于安慰剂组.在三个梗死组中,梗死区的重量无显著差异.enalapril治疗组血浆AngⅡ浓度降低,而losartan治疗组中血浆AngⅡ浓度升高.梗死后安慰剂组心脏局部AnsⅡ浓度明显高于假手术组、enalanril和losartan治疗组.enalanril及losartan可降低血浆ET-1浓度.结论血管紧张素转换酶抑制剂及血管紧张素Ⅱ受体拮抗剂对阻止心室重构的发展具有相同作用.

Objective To study the comparative cardiac effects, of angiotensin-convertig enzyme (ACE) inhibitor and selective angiotensin Ⅱ type Ⅰ receptor (AT1 )antagonist on ventricular remodeling in experimental myocardial in-farctional rats Methods 24 hours after coronary ligation, rats were randomized to enalapril losartan and placebo, and treated for 6 weeks. Sham-operated rats served as controls. After 6 weeks, myocardial collagen content plasma and cardiac angiotensin I concentration, plasma endothelin concentration,body weight, weight of infarcted region and the ratio of cardiac weight to body weight were measured. Result The ratio of cardiac weight to body weight and myocardial collagen content in enalapril-and losartan-treated infarct rats were increased compared with sham-operated rats and decreased compared with placebo-treated infarct rats The weight of infarcted region had no significant difference in the groups of infarct rats Plasma Ang Ⅱ concentration was decreased by enalapril and increased by losartan. Cardiac Ang I concentration was increased in placebo group rats compared with the other groups. Enelapril and losartan can decrease the plasma endothelin concentration Conclusion Angiotensin-converting enzyme inhibitor and angiotensin Ⅱ type I receptor antagonist are equally effective in preventing ventricular remodeling.