吴强,李隆贵,蔡运昌,杨天和,王晓峰,耿召华
WU Qiang 1, LI Long gui 2, CAI Yun chang 1, YANG Tian he 1, WANG Xiao feng 1, GENG Zhao hua 2 (1. Department of Cardiology, Guizhou Province People's Hospital, Guiyang 550002, China; 2. Department of Cardiology, Xinqiao Hospital, the Third Military Medical University, Chongqing 400037, China)

• 1:贵州省人民医院心内科
• 2:第三军医大学附属新桥医院心内科
• 3:贵州省人民医院心内科
• 4:贵州省人民医院心内科

摘要(Abstract)：

目的 :探讨心肌梗死 (MI)后心肌病理形态学和心肌细胞凋亡的变化、意义及卡维地洛 (CAR)治疗的作用机制。方法 :观察雄性Wistar大鼠MI后的血流动力学参数、心室重塑指标、心肌病理形态学及心肌细胞凋亡的改变 ,并于MI后 1周开始对大鼠进行 7周的CAR和美托洛尔 (MET)干预 ,观察CAR和MET对上述指标的影响。结果 :MI后大鼠MAP和±dp/dtmax显著降低 ,左室舒张期末压 (LVEDP)、左心室湿重 /体重 (LVW /BW)、右心室湿重 /体重 (RVW/BW )和心肌细胞凋亡指数明显增高 ,心肌出现明显病理形态学改变 ;CAR和MET可不同程度地改善MI大鼠心功能和心肌超微结构异常 ,CAR降低心肌细胞凋亡指数的效果优于MET。结论 :心肌细胞凋亡在MI后充血性心力衰竭的发生、发展过程中起着重要的作用 ,CAR可有效地减少MI后心肌细胞凋亡 ,改善心肌病理形态学异常
Objective: To study the changes of myocardium pathomorphology and apoptosis in the progression of heart failure, to explore the mechanisms of carvedilol (CAR) in therapies for heart failure.Methods: An animal model of myocardial infarction (MI)was induced with male waistar rats by the left coronary artery ligation . Hemodyanmics, ventricular remodeling parameters, myocardium pathomorphology and cardiac myocyte apoptosis were investigated in MI group at the 8 th week after operation and treated experimental groups in which rats were treated with CAR and metoprolol (MET) for 7 weeks since 1 week after operation. The sham operated rats (SH group, n=10) served as control.Results: Compared with the SH group, mean arterial pressure and ±dp/dt max markedly decreased, left ventricular end diastolic pressure, the ratio of right/left ventricular weight/body and apoptosis index significantly increased in the MI group. There were marked abnormality in microstructure and ultrastructure in myocardium after MI. Both of CAR and MET improved heart function, myocardial microstructure and ultrastructure in rats with MI. The apoptosis index was significantly lower in CAR group than that in MET group. Conclusion: Myocardiocyte apoptosis may play a key role in the occurrence and progression of congestive heart failure. CAR can effectively decrease the number of myocardiocyte apoptosis, improve myocardial microstructure, and ultrastructure.

关键词(KeyWords)： 肾上腺素能α受体阻滞剂;肾上腺素能β受体阻滞剂;心肌梗塞;病理学;细胞周期
adrenergic alpha receptor blockaders; adrenogic beta receptor blockaders; myocardial infarction; pathology; cell cycle

Abstract:

Keywords:

基金项目(Foundation): 贵州省科技厅科学技术基金资助项目 (NO 30 4 4 )

作者(Authors): 吴强,李隆贵,蔡运昌,杨天和,王晓峰,耿召华
WU Qiang 1, LI Long gui 2, CAI Yun chang 1, YANG Tian he 1, WANG Xiao feng 1, GENG Zhao hua 2 (1. Department of Cardiology, Guizhou Province People's Hospital, Guiyang 550002, China; 2. Department of Cardiology, Xinqiao Hospital, the Third Military Medical University, Chongqing 400037, China)

DOI: 10.19367/j.cnki.1000-2707.2002.06.003

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