不同剂量培哚普利对兔急性心肌梗死后内皮祖细胞及心功能的影响

发布时间：2018-03-22 20:30

本文选题：培哚普利　切入点：急性心肌梗死　出处：《山东大学学报(医学版)》2017年02期 　论文类型：期刊论文

【摘要】：目的探讨不同剂量培哚普利对兔急性心肌梗死(AMI)后外周循环内皮祖细胞(EPCs)的动员作用及心脏收缩功能的影响。方法建立兔心肌梗死模型,随机分为假手术组(n=7)、AMI组(n=6)、小剂量培哚普利组(n=6)和大剂量培哚普利组(n=6)。应用流式细胞技术分别检测1、3、7、14、28 d循环血中EPCs数量,并于模型建立28 d采用心脏多普勒超声技术测量每搏输出量(SV)、左心室射血分数(LVEF)和左心室短轴缩短率(LVFS),取梗死部位心肌组织行HE染色,观察各组心肌细胞的坏死及紊乱程度。结果 AMI后经培哚普利干预,兔循环血中EPCs水平显著升高,大剂量培哚普利组效果显著(P0.05)。AMI 28 d,AMI组与假手术组相比较,LVFS、SV、LVEF显著减低,经培哚普利干预后各指标显著增高,大剂量培哚普利组增高显著(P0.05)。AMI组、小剂量培哚普利组和大剂量培哚普利组EPCs与LVEF呈相关性(R=0.468,P=0.05)。HE染色显示,与假手术组相比,AMI组心肌细胞基本被瘢痕组织替代,且其间有较多淋巴细胞浸润,小剂量培哚普利组见少量固缩心肌细胞及较多瘢痕组织,细胞肿胀变性及紊乱程度减轻,大剂量培哚普利组改善更为明显,可见较多正常心肌细胞存在及少量瘢痕组织。结论培哚普利可促进兔AMI后外周循环血中EPCs动员,提高LVEF、LVFS、SV,改善心功能,降低心肌细胞坏死及紊乱程度,且大剂量培哚普利干预效果更为显著,心脏收缩改善程度可能与EPCs水平有一定相关性。
[Abstract]:Objective to investigate the effects of different doses of perindopril on the mobilization of peripheral endothelial progenitor cells (EPCs) and cardiac contractile function after acute myocardial infarction (AMI) in rabbits. The patients were randomly divided into two groups: sham operation group, small dose perindopril group, and high dose perindopril group. Flow cytometry was used to detect the amount of EPCs in circulating blood for 28 days. On the 28th day after the establishment of the model, the ventricular output volume (SVV), left ventricular ejection fraction (LVEF) and left ventricular short axis shortening rate (LVFSN) were measured by Doppler echocardiography. The myocardial tissue of the infarcted area was stained with HE. Results after the intervention of perindopril after AMI, the level of EPCs in circulating blood of rabbits was significantly increased, and the effect of high dose perindopril group was significantly lower than that of sham operation group. The indexes of perindopril were significantly higher than those of high dose perindopril group (P 0.05), low dose perindopril group and high dose perindopril group (P < 0 05). The correlation between EPCs and LVEF was observed in the high dose perindopril group and high dose perindopril group. Compared with sham operation group, myocardial cells in AMI group were basically replaced by scar tissue, and there were more lymphocytes infiltrated in them. A small amount of pyknotic cardiomyocytes and more scar tissue were found in low dose perindopril group, and the degree of cell swelling, degeneration and disorder was reduced. Conclusion Perindopril can promote the mobilization of EPCs in peripheral circulation of rabbits after AMI, improve LVFSV of LVEF, improve cardiac function, improve cardiac function, and improve the cardiac function of rabbits with high dose perindopril, and the presence of more normal cardiomyocytes and a small amount of scar tissue in high dose perindopril group. The degree of myocardial necrosis and disturbance was decreased, and the effect of high dose perindopril was more obvious. The improvement of cardiac contraction might be related to the level of EPCs.
【作者单位】：济南军区总医院心内科;济南军区总医院干部保健二科;济南军区总医院检验科;济南军区总医院病理科;
【基金】：济南军区总医院院长基金(2013MS005)
【分类号】：R542.22

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